Healthcare Provider Details

I. General information

NPI: 1558392001
Provider Name (Legal Business Name): ROBIN RENA GIVENS RPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROBIN RENA GIVENS-BANKS RPT

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4231 BLAGDEN AVE NW
WASHINGTON DC
20011-4253
US

IV. Provider business mailing address

4231 BLAGDEN AVE NW
WASHINGTON DC
20011-4253
US

V. Phone/Fax

Practice location:
  • Phone: 202-882-0970
  • Fax: 202-882-4080
Mailing address:
  • Phone: 202-882-0970
  • Fax: 202-882-4080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2855
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: