Provider Demographics
NPI:1629404900
Name:WILLE, ROBIN JULIANA
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:JULIANA
Last Name:WILLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1145 ROSS RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:SAN BENITO
Mailing Address - State:TX
Mailing Address - Zip Code:78520-4338
Mailing Address - Country:US
Mailing Address - Phone:956-361-6000
Mailing Address - Fax:956-361-6060
Practice Address - Street 1:1145 ROSS RD
Practice Address - Street 2:SUITE E
Practice Address - City:SAN BENITO
Practice Address - State:TX
Practice Address - Zip Code:78520-4338
Practice Address - Country:US
Practice Address - Phone:956-361-6000
Practice Address - Fax:956-361-6060
Is Sole Proprietor?:No
Enumeration Date:2013-09-18
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN201670224Z00000X
TX211191224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant