Provider Demographics
NPI:1639282403
Name:TUTOR, ROBIN (OTR/L)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:TUTOR
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 1:2504 AMELIA RD
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520
Mailing Address - Country:US
Mailing Address - Phone:919-553-2180
Mailing Address - Fax:919-553-2180
Practice Address - Street 1:4901 GLENWOOD AVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-3820
Practice Address - Country:US
Practice Address - Phone:919-420-0334
Practice Address - Fax:919-420-0299
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC388225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7384127Medicaid