Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 2827-024 | WI |
N | 2251G0304X | Physical Therapist - Geriatrics | 2827-024 | WI |
NPI | 1225213390 |
---|---|
Provider Name | Mrs. Cheryl Ann Robillard |
First Address | Wauwatosa, WI 53226-3312 |
Second Address | Glendale, WI 53209-3802 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2008 |
Last Update Date | 08/08/2014 |