Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 1592 | LA |
NPI | 1417253360 |
---|---|
Provider Name | Dr. Dana Robinson |
First Address | Prairieville, LA 70769-4587 |
Second Address | Baton Rouge, LA 70810-3008 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2011 |
Last Update Date | 03/11/2016 |