Provider Demographics
NPI:1467431197
Name:ABBOTT, ROBIN CAROL (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:CAROL
Last Name:ABBOTT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1432A 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:FORT KNOX
Mailing Address - State:KY
Mailing Address - Zip Code:40121-2227
Mailing Address - Country:US
Mailing Address - Phone:704-804-3810
Mailing Address - Fax:
Practice Address - Street 1:645 KNOX BLVD
Practice Address - Street 2:
Practice Address - City:RADCLIFF
Practice Address - State:KY
Practice Address - Zip Code:40160-1514
Practice Address - Country:US
Practice Address - Phone:704-804-3810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-11
Last Update Date:2014-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5947225XP0200X
KYBOTOCT00210728225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics