Provider Demographics
NPI:1447215058
Name:GARDINER, ROBIN (OTA)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:GARDINER
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:DE
Mailing Address - Zip Code:19934-1121
Mailing Address - Country:US
Mailing Address - Phone:302-697-2173
Mailing Address - Fax:302-697-3406
Practice Address - Street 1:7 FRONT ST
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:DE
Practice Address - Zip Code:19934-1121
Practice Address - Country:US
Practice Address - Phone:302-697-2173
Practice Address - Fax:302-697-3406
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEU2-0000525224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant