Provider Demographics
NPI:1922263334
Name:DAL SANTO, ROBIN L (COTA/L)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:L
Last Name:DAL SANTO
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11597 KENNEDY PL
Mailing Address - Street 2:
Mailing Address - City:CEDAR LAKE
Mailing Address - State:IN
Mailing Address - Zip Code:46303-8208
Mailing Address - Country:US
Mailing Address - Phone:219-365-1905
Mailing Address - Fax:
Practice Address - Street 1:11597 KENNEDY PL
Practice Address - Street 2:
Practice Address - City:CEDAR LAKE
Practice Address - State:IN
Practice Address - Zip Code:46303-8208
Practice Address - Country:US
Practice Address - Phone:219-365-1905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-24
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN32000120A224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant