Provider Demographics
NPI:1508009044
Name:ROBINSON, JENNIFER W (PT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:W
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 GARRISONVILLE RD, 109
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554
Mailing Address - Country:US
Mailing Address - Phone:703-522-2727
Mailing Address - Fax:540-288-3327
Practice Address - Street 1:450 GARRISONVILLE RD, 109
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554
Practice Address - Country:US
Practice Address - Phone:703-522-2727
Practice Address - Fax:540-288-3327
Is Sole Proprietor?:No
Enumeration Date:2009-04-14
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501014126225100000X
VA2305207668225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist