Provider Demographics
NPI:1013341593
Name:ROBINSON, KASSIE NICOLE (MS)
Entity Type:Individual
Prefix:
First Name:KASSIE
Middle Name:NICOLE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:KASSIE
Other - Middle Name:NICOLE
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:1810 OZARKA COLLEGE DR
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:AR
Mailing Address - Zip Code:72560-6455
Mailing Address - Country:US
Mailing Address - Phone:870-269-2110
Mailing Address - Fax:
Practice Address - Street 1:1810 OZARKA COLLEGE DR
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:AR
Practice Address - Zip Code:72560-6455
Practice Address - Country:US
Practice Address - Phone:870-269-2110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-03
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist