Provider Demographics
NPI:1578108114
Name:MARQUES, ROBYN JUSTICE (OTR/L)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:JUSTICE
Last Name:MARQUES
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 1:2030 EAST CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-8403
Mailing Address - Country:US
Mailing Address - Phone:859-312-6725
Mailing Address - Fax:
Practice Address - Street 1:200 MERIDIAN WAY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-3331
Practice Address - Country:US
Practice Address - Phone:859-353-6777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-07
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY135654225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist