1467732925 NPI number — BARBARA ROBERTSON LCPAT, ATR-BC

Table of content: BARBARA ROBERTSON LCPAT, ATR-BC (NPI 1467732925)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467732925 NPI number — BARBARA ROBERTSON LCPAT, ATR-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROBERTSON
Provider First Name:
BARBARA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCPAT, ATR-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467732925
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/03/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3091 SCOTTSBOROUGH WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RIVA
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21140-1420
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-353-5708
Provider Business Mailing Address Fax Number:
443-914-0554

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1203 WEST ST STE D
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANNAPOLIS
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21401-3662
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-353-5708
Provider Business Practice Location Address Fax Number:
443-914-0554
Provider Enumeration Date:
08/27/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 221700000X , with the licence number:  ATC011 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: ATC011 . This is a "LCPAT - ART THERAPIST LICENSE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com