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General NPI Number Information
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NPI Number | 1104916501
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Entity Type | Individual
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Provider Name | CASSANDRA DENISE ROBINSON ATC
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Gender | Female
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Dates
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Enumeration Date | 10/14/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 20952 E 12 MILE RD SUITE 110
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48081-3200
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Country | US
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Telephone | 586-498-3503
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Fax |
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Provider Business Mailing Address
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Address Line | 24624 LAKE MEADOW DR
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City | HARRISON TOWNSHIP
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State | MI
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Zip | 48045-3126
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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