Provider Demographics
NPI:1952758591
Name:ROBBINS, DIANNE W (PTA)
Entity Type:Individual
Prefix:
First Name:DIANNE
Middle Name:W
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 MASSONOFF CT
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2061
Mailing Address - Country:US
Mailing Address - Phone:703-244-9154
Mailing Address - Fax:
Practice Address - Street 1:1715 N GEORGE MASON DR
Practice Address - Street 2:SUITE 503
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3609
Practice Address - Country:US
Practice Address - Phone:703-525-5542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-24
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306000199174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist