Provider Demographics
NPI:1912285370
Name:BABER, MANDY HOBACK (OTR/L)
Entity Type:Individual
Prefix:
First Name:MANDY
Middle Name:HOBACK
Last Name:BABER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1695 FOUNDING WAY RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24523-6861
Mailing Address - Country:US
Mailing Address - Phone:540-798-5132
Mailing Address - Fax:
Practice Address - Street 1:1695 FOUNDING WAY RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:VA
Practice Address - Zip Code:24523-6861
Practice Address - Country:US
Practice Address - Phone:540-798-5132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-02
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119003223225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation