Provider Demographics
NPI:1588789556
Name:ROBLIN, DANIELLE RICHARDSON (LOTR)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:RICHARDSON
Last Name:ROBLIN
Suffix:
Gender:F
Credentials:LOTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13762 SHARON AVE
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-5935
Mailing Address - Country:US
Mailing Address - Phone:225-355-4461
Mailing Address - Fax:225-355-4488
Practice Address - Street 1:3940 PRESCOTT RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70805-5143
Practice Address - Country:US
Practice Address - Phone:225-355-4461
Practice Address - Fax:225-355-4488
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAZ12422225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1477915Medicaid