Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 012706 | NY |
NPI | 1003128851 |
---|---|
Provider Name | Miss Ingrid Dawn Robinson |
First Address | New Rochelle, NY 10801-7265 |
Second Address | New Rochelle, NY 10801-7265 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2010 |
Last Update Date | 09/07/2010 |