Provider Demographics
NPI:1619253515
Name:ROBINSON, TRICIA LYNN (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:TRICIA
Middle Name:LYNN
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 HARTWICK LN
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN INN
Mailing Address - State:SC
Mailing Address - Zip Code:29644-8023
Mailing Address - Country:US
Mailing Address - Phone:864-770-5597
Mailing Address - Fax:864-409-1455
Practice Address - Street 1:201 HARTWICK LN
Practice Address - Street 2:
Practice Address - City:FOUNTAIN INN
Practice Address - State:SC
Practice Address - Zip Code:29644-8023
Practice Address - Country:US
Practice Address - Phone:864-770-5597
Practice Address - Fax:864-409-1455
Is Sole Proprietor?:No
Enumeration Date:2011-10-24
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2942225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics