Provider Demographics
NPI:1588784011
Name:ROBINSON, KIMBERLY RENEE (PT, OCS)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:RENEE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:PT, OCS
Other - Prefix:
Other - First Name:KIM
Other - Middle Name:RENEE
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, OCS
Mailing Address - Street 1:3400 W TECUMSEH RD STE 101
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-1810
Mailing Address - Country:US
Mailing Address - Phone:405-360-6764
Mailing Address - Fax:405-360-6769
Practice Address - Street 1:3400 W TECUMSEH RD
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-1810
Practice Address - Country:US
Practice Address - Phone:405-447-9417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKPT 2078174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist