Provider Demographics
NPI:1376319046
Name:ROBINSON, GAGE ROBERT (OT/L)
Entity Type:Individual
Prefix:
First Name:GAGE
Middle Name:ROBERT
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:OT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 HUME BEDFORD RD
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:KY
Mailing Address - Zip Code:40361-1016
Mailing Address - Country:US
Mailing Address - Phone:859-707-5766
Mailing Address - Fax:
Practice Address - Street 1:690 MASON HEADLEY RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-2384
Practice Address - Country:US
Practice Address - Phone:859-278-9080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY289166225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist