Provider Demographics
NPI:1053712950
Name:ROBINSON, AZIAH (OTR/L)
Entity type:Individual
Prefix:
First Name:AZIAH
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:AZIAH
Other - Middle Name:
Other - Last Name:BATSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2520 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72076-4214
Mailing Address - Country:US
Mailing Address - Phone:501-982-0528
Mailing Address - Fax:
Practice Address - Street 1:2400 W MAIN ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72076-4212
Practice Address - Country:US
Practice Address - Phone:501-982-0528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-10
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARO-T1428225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist