Provider Demographics
NPI:1285780551
Name:ATWELL, ROBIN LEIGH (OTRL)
Entity type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:LEIGH
Last Name:ATWELL
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 PRESTON AVE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-1506
Mailing Address - Country:US
Mailing Address - Phone:859-699-9623
Mailing Address - Fax:
Practice Address - Street 1:213 PRESTON AVE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-1506
Practice Address - Country:US
Practice Address - Phone:859-699-9623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR2508171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor