Provider Demographics
NPI:1386009066
Name:ROBINSON, CORTNEY (LMBT, MMP)
Entity Type:Individual
Prefix:MISS
First Name:CORTNEY
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LMBT, MMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1331 4TH STREET DR NW
Mailing Address - Street 2:SUITE E
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-2578
Mailing Address - Country:US
Mailing Address - Phone:828-322-6979
Mailing Address - Fax:
Practice Address - Street 1:1331 4TH STREET DR NW
Practice Address - Street 2:SUITE E
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-2578
Practice Address - Country:US
Practice Address - Phone:828-322-6979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-22
Last Update Date:2015-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15166225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist