Provider Demographics
NPI:1336913433
Name:ROBINSON, UTISHA (REIKI PROVIDER)
Entity Type:Individual
Prefix:
First Name:UTISHA
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:REIKI PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BLADES DR APT 1
Mailing Address - Street 2:
Mailing Address - City:NEW MADRID
Mailing Address - State:MO
Mailing Address - Zip Code:63869-1110
Mailing Address - Country:US
Mailing Address - Phone:573-805-9680
Mailing Address - Fax:
Practice Address - Street 1:1 BLADES DR APT 1
Practice Address - Street 2:
Practice Address - City:NEW MADRID
Practice Address - State:MO
Practice Address - Zip Code:63869-1110
Practice Address - Country:US
Practice Address - Phone:573-805-9007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty