Provider Demographics
NPI:1093985426
Name:RUBINO, ANGEL LYNN (OTR)
Entity Type:Individual
Prefix:MRS
First Name:ANGEL
Middle Name:LYNN
Last Name:RUBINO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 646
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:VT
Mailing Address - Zip Code:05091-0646
Mailing Address - Country:US
Mailing Address - Phone:802-457-4921
Mailing Address - Fax:802-457-4921
Practice Address - Street 1:1206 ROUTE 12
Practice Address - Street 2:SUITE 2
Practice Address - City:WOODSTOCK
Practice Address - State:VT
Practice Address - Zip Code:05091-7943
Practice Address - Country:US
Practice Address - Phone:802-291-2382
Practice Address - Fax:802-457-4921
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0720000131225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist