Provider Demographics
NPI:1881042323
Name:ROBINSON, TRAVIS (OTR/L)
Entity Type:Individual
Prefix:
First Name:TRAVIS
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:M
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 1:5808 WAINWRIGHT AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20851-1946
Mailing Address - Country:US
Mailing Address - Phone:301-855-0389
Mailing Address - Fax:
Practice Address - Street 1:5808 WAINWRIGHT AVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20851-1946
Practice Address - Country:US
Practice Address - Phone:301-855-0389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-25
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIOT01564225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI0614OtherNEIGHBORHOOD HEALTH PLAN
RIES01788Medicaid
RISB870OtherBLUE CROSS