Provider Demographics
NPI:1801913421
Name:DOBRAN, LILYBETH CONTRERAS (COTA)
Entity type:Individual
Prefix:
First Name:LILYBETH
Middle Name:CONTRERAS
Last Name:DOBRAN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6214 RONALD ST NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-1042
Mailing Address - Country:US
Mailing Address - Phone:330-498-0134
Mailing Address - Fax:
Practice Address - Street 1:435 AVIS AVE NW
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-3555
Practice Address - Country:US
Practice Address - Phone:330-837-1741
Practice Address - Fax:330-837-4618
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA 2863224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant