Provider Demographics
NPI:1720467517
Name:ROBINSON, CHONTANITE (COTA)
Entity Type:Individual
Prefix:MS
First Name:CHONTANITE
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 S 42ND ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40211-2749
Mailing Address - Country:US
Mailing Address - Phone:502-408-9156
Mailing Address - Fax:
Practice Address - Street 1:135 HOYT ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30601-2646
Practice Address - Country:US
Practice Address - Phone:706-549-0031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-26
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOTA001894225XM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XM0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistMental Health