Provider Demographics
NPI:1538920962
Name:COBB, BRIANNA ROSE
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:ROSE
Last Name:COBB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 PICKARD RD
Mailing Address - Street 2:
Mailing Address - City:CANTERBURY
Mailing Address - State:NH
Mailing Address - Zip Code:03224-2320
Mailing Address - Country:US
Mailing Address - Phone:120-727-9133
Mailing Address - Fax:
Practice Address - Street 1:151 LANGLEY PKWY
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-7533
Practice Address - Country:US
Practice Address - Phone:603-224-0777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-22
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist