Provider Demographics
NPI:1811703440
Name:ENCOMPASS PELVIC HEALTH PLLC
Entity type:Organization
Organization Name:ENCOMPASS PELVIC HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:YEBRA
Authorized Official - Suffix:
Authorized Official - Credentials:OTD
Authorized Official - Phone:207-463-6361
Mailing Address - Street 1:218 BENNETT POND RD
Mailing Address - Street 2:
Mailing Address - City:CANTERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06331-1528
Mailing Address - Country:US
Mailing Address - Phone:207-463-6361
Mailing Address - Fax:
Practice Address - Street 1:20 S ANGUILLA RD
Practice Address - Street 2:
Practice Address - City:PAWCATUCK
Practice Address - State:CT
Practice Address - Zip Code:06379-1447
Practice Address - Country:US
Practice Address - Phone:207-463-6361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-09
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty