Provider Demographics
NPI:1194930164
Name:ROBINSON, DANYETTE DAINIQUE
Entity type:Individual
Prefix:MRS
First Name:DANYETTE
Middle Name:DAINIQUE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DANYETTE
Other - Middle Name:DAINIQUE
Other - Last Name:STANFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5631 HARBOR VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:MD
Mailing Address - Zip Code:21225-2967
Mailing Address - Country:US
Mailing Address - Phone:410-589-0464
Mailing Address - Fax:
Practice Address - Street 1:6917 ARLINGTON RD
Practice Address - Street 2:SUITE 226
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-5211
Practice Address - Country:US
Practice Address - Phone:301-657-5650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-13
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA2852225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant