Provider Demographics
NPI:1407149032
Name:ROBEY, CAROLYN MICHELLE (COTA)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:MICHELLE
Last Name:ROBEY
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 FARMHOUSE LN APT H
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-7142
Mailing Address - Country:US
Mailing Address - Phone:317-557-2882
Mailing Address - Fax:
Practice Address - Street 1:328 FARMHOUSE LN APT H
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-7142
Practice Address - Country:US
Practice Address - Phone:317-557-2882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-16
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN32001999A224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant