Provider Demographics
NPI:1811926215
Name:TATE, ROBIN L (OT)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:L
Last Name:TATE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:L
Other - Last Name:IMLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:RR 1 BOX 209B
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16693-9724
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:808 HANNAH ST
Practice Address - Street 2:
Practice Address - City:HOUTZDALE
Practice Address - State:PA
Practice Address - Zip Code:16651-1241
Practice Address - Country:US
Practice Address - Phone:814-378-3688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC003393L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist