Healthcare Provider Details

I. General information

NPI: 1033129754
Provider Name (Legal Business Name): MICHELLE EVELYN KOBE OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE E KOBE OTR/L

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N CHURCH ST
MONROE NC
28112-4804
US

IV. Provider business mailing address

3918 ETHEREDGE ST
INDIAN TRAIL NC
28079-7597
US

V. Phone/Fax

Practice location:
  • Phone: 704-502-5845
  • Fax:
Mailing address:
  • Phone: 704-502-5845
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number4357
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: