Provider Demographics
NPI:1487830485
Name:ROBINSON, CLAREASE (OTR/L)
Entity Type:Individual
Prefix:
First Name:CLAREASE
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MRS
Other - First Name:CLAREASE
Other - Middle Name:
Other - Last Name:SANDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:6100 MILLER AVE
Mailing Address - Street 2:
Mailing Address - City:GARY
Mailing Address - State:IN
Mailing Address - Zip Code:46403-2469
Mailing Address - Country:US
Mailing Address - Phone:219-427-0196
Mailing Address - Fax:219-427-0197
Practice Address - Street 1:6100 MILLER AVE
Practice Address - Street 2:
Practice Address - City:GARY
Practice Address - State:IN
Practice Address - Zip Code:46403-2469
Practice Address - Country:US
Practice Address - Phone:219-427-0196
Practice Address - Fax:219-427-0197
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-21
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31001112A174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist