Provider Demographics
NPI:1528500873
Name:ROBERTSON, APRIL LEE (COTA/L)
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:LEE
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 WOOD ST
Mailing Address - Street 2:APT C1
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-1534
Mailing Address - Country:US
Mailing Address - Phone:276-734-1312
Mailing Address - Fax:
Practice Address - Street 1:101 WOOD ST
Practice Address - Street 2:APT C1
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-1534
Practice Address - Country:US
Practice Address - Phone:276-734-1312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-16
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0131001390224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant