Provider Demographics
NPI:1346511573
Name:ROBINSON, LADONNA (PTA)
Entity Type:Individual
Prefix:
First Name:LADONNA
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:656 CHARANTE CT
Mailing Address - Street 2:APT 204
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-4760
Mailing Address - Country:US
Mailing Address - Phone:205-240-8849
Mailing Address - Fax:
Practice Address - Street 1:656 CHARANTE CT
Practice Address - Street 2:APT 204
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-4760
Practice Address - Country:US
Practice Address - Phone:205-240-8849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-19
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA3668174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist