Provider Demographics
NPI:1447780168
Name:STARR, ROBIN SUE (ATC)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:SUE
Last Name:STARR
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3279 W 300 S
Mailing Address - Street 2:
Mailing Address - City:RENSSELAER
Mailing Address - State:IN
Mailing Address - Zip Code:47978-7275
Mailing Address - Country:US
Mailing Address - Phone:219-688-3453
Mailing Address - Fax:
Practice Address - Street 1:3279 W 300 S
Practice Address - Street 2:
Practice Address - City:RENSSELAER
Practice Address - State:IN
Practice Address - Zip Code:47978-7275
Practice Address - Country:US
Practice Address - Phone:219-688-3453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36002735A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer