Provider Demographics
NPI:1225219736
Name:LEATHERBARROW, ROBIN LYNN (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:LYNN
Last Name:LEATHERBARROW
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3041 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:NORTH COLLINS
Mailing Address - State:NY
Mailing Address - Zip Code:14111-9712
Mailing Address - Country:US
Mailing Address - Phone:716-982-5909
Mailing Address - Fax:
Practice Address - Street 1:3041 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:NORTH COLLINS
Practice Address - State:NY
Practice Address - Zip Code:14111-9712
Practice Address - Country:US
Practice Address - Phone:716-982-5909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-27
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008912-1225XP0200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY008912-1OtherNEW YORK STATE LICENSURE