Provider Demographics
NPI:1467658708
Name:REVOIR, ROSEMARY ROBISCH (NBCT)
Entity Type:Individual
Prefix:MRS
First Name:ROSEMARY
Middle Name:ROBISCH
Last Name:REVOIR
Suffix:
Gender:F
Credentials:NBCT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-1609
Mailing Address - Country:US
Mailing Address - Phone:606-521-2316
Mailing Address - Fax:
Practice Address - Street 1:305 W 5TH ST
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-1609
Practice Address - Country:US
Practice Address - Phone:606-521-2316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY02038222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY02038OtherFIRST STEPS