Provider Demographics
NPI:1801168679
Name:ROBINSON, KIMBERLY MARA (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:MARA
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 ORLEANS RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHATHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02650-1154
Mailing Address - Country:US
Mailing Address - Phone:508-945-9611
Mailing Address - Fax:
Practice Address - Street 1:390 ORLEANS RD
Practice Address - Street 2:
Practice Address - City:NORTH CHATHAM
Practice Address - State:MA
Practice Address - Zip Code:02650-1154
Practice Address - Country:US
Practice Address - Phone:508-945-9611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8839225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist