Provider Demographics
NPI:1407022676
Name:ROBINSON, TRICIA LYNN (COTA)
Entity Type:Individual
Prefix:
First Name:TRICIA
Middle Name:LYNN
Last Name:ROBINSON
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 1:114 OAK HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:TIMBERLAKE
Mailing Address - State:NC
Mailing Address - Zip Code:27583-8817
Mailing Address - Country:US
Mailing Address - Phone:336-592-0117
Mailing Address - Fax:
Practice Address - Street 1:901 RIDGE RD
Practice Address - Street 2:
Practice Address - City:ROXBORO
Practice Address - State:NC
Practice Address - Zip Code:27573-4511
Practice Address - Country:US
Practice Address - Phone:336-599-0106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4796224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant