Provider Demographics
NPI:1710183884
Name:ROBISON, KELLI J (OTR)
Entity Type:Individual
Prefix:MS
First Name:KELLI
Middle Name:J
Last Name:ROBISON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:966 SAMPLES LANE NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318
Mailing Address - Country:US
Mailing Address - Phone:404-713-3221
Mailing Address - Fax:404-794-7065
Practice Address - Street 1:966 SAMPLES LANE NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318
Practice Address - Country:US
Practice Address - Phone:404-713-3221
Practice Address - Fax:404-794-7065
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT002263225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics