Provider Demographics
NPI:1306019070
Name:ROBINSON, HEATHER MICHELLE (LMT)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:MICHELLE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1709 CLEVELAND HWY
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-1353
Mailing Address - Country:US
Mailing Address - Phone:770-532-2778
Mailing Address - Fax:770-532-4845
Practice Address - Street 1:1709 CLEVELAND HWY
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-1353
Practice Address - Country:US
Practice Address - Phone:770-532-2778
Practice Address - Fax:770-532-4845
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT000514225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist