Provider Demographics
NPI:1134505019
Name:ROBINS, MINDY
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:
Last Name:ROBINS
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 1:5408 VIKING RD NE
Mailing Address - Street 2:
Mailing Address - City:MOSES LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98837-3748
Mailing Address - Country:US
Mailing Address - Phone:509-750-6112
Mailing Address - Fax:
Practice Address - Street 1:5408 VIKING RD NE
Practice Address - Street 2:
Practice Address - City:MOSES LAKE
Practice Address - State:WA
Practice Address - Zip Code:98837-3748
Practice Address - Country:US
Practice Address - Phone:509-750-6112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-03
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist