Provider Demographics
NPI:1881198174
Name:ROBINE, JULIANA (MPH, PTA, CHES)
Entity Type:Individual
Prefix:
First Name:JULIANA
Middle Name:
Last Name:ROBINE
Suffix:
Gender:F
Credentials:MPH, PTA, CHES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4707 MILL ST
Mailing Address - Street 2:
Mailing Address - City:MANTUA
Mailing Address - State:OH
Mailing Address - Zip Code:44255-8934
Mailing Address - Country:US
Mailing Address - Phone:330-274-2747
Mailing Address - Fax:330-274-0337
Practice Address - Street 1:4707 MILL ST
Practice Address - Street 2:
Practice Address - City:MANTUA
Practice Address - State:OH
Practice Address - Zip Code:44255-8934
Practice Address - Country:US
Practice Address - Phone:330-274-2747
Practice Address - Fax:330-274-0337
Is Sole Proprietor?:No
Enumeration Date:2018-03-21
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPTA002268225200000X
OHCHES24962174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH02215OtherCERTIFIED WELLCOACH LIFESTYLE COACH
OH24962OtherCERTIFIED HEALTH EDUCATION SPECIALIST
OHPTA002268OtherPHYSICAL THERAPIST ASSISTANT