Provider Demographics
NPI:1306181227
Name:ROBINETTE, MICHELLE G (COTA)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:G
Last Name:ROBINETTE
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5297 TURKEY POINT RD
Mailing Address - Street 2:
Mailing Address - City:NORTH EAST
Mailing Address - State:MD
Mailing Address - Zip Code:21901
Mailing Address - Country:US
Mailing Address - Phone:318-446-5086
Mailing Address - Fax:
Practice Address - Street 1:5297 TURKEY POINT RD
Practice Address - Street 2:
Practice Address - City:NORTH EAST
Practice Address - State:MD
Practice Address - Zip Code:21901-6234
Practice Address - Country:US
Practice Address - Phone:318-446-5086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-04
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA01791224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant