Provider Demographics
NPI:1003282815
Name:GOLDEN, ROBIN (PT,DPT)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:GOLDEN
Suffix:
Gender:F
Credentials:PT,DPT
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:PETRONELLA MARIA
Other - Last Name:HEKKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:960 E JACOB ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-8159
Mailing Address - Country:US
Mailing Address - Phone:480-239-3578
Mailing Address - Fax:
Practice Address - Street 1:960 E JACOB ST
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-8159
Practice Address - Country:US
Practice Address - Phone:480-239-3578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-15
Last Update Date:2015-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9980225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist