Provider Demographics
NPI:1427300490
Name:CHARLTON-ROBINSON, DIONNE
Entity type:Individual
Prefix:MRS
First Name:DIONNE
Middle Name:
Last Name:CHARLTON-ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3643 CATALPA AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46228-1087
Mailing Address - Country:US
Mailing Address - Phone:260-417-9253
Mailing Address - Fax:
Practice Address - Street 1:8103 E US HIGHWAY 36
Practice Address - Street 2:#129
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-7964
Practice Address - Country:US
Practice Address - Phone:317-691-3667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-15
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN32000925A224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant