Provider Demographics
NPI:1548081870
Name:TEBBE, YVONNE KATHLEEN (OTD, LOTR)
Entity type:Individual
Prefix:
First Name:YVONNE
Middle Name:KATHLEEN
Last Name:TEBBE
Suffix:
Gender:F
Credentials:OTD, LOTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 MEDICAL PARK BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71360-8426
Mailing Address - Country:US
Mailing Address - Phone:318-449-0451
Mailing Address - Fax:
Practice Address - Street 1:101 MEDICAL PARK BLVD STE C
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-8426
Practice Address - Country:US
Practice Address - Phone:318-449-0451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-19
Last Update Date:2024-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA301175225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics