MEDICARE: ROBINS NEST THERAPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	08-0039	NV

General Provider Information

NPI Number	:	1609210418
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBINS NEST THERAPY LLC

Provider Business Mailing Address
First Line	:	8414 W. FARM ROAD 180-505
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-5006
Country	:	US
Telephone Number	:	702-463-5728
Fax Number	:

Provider Business Practice Location Address
First Line	:	8414 W. FARM ROAD 180-505
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-5006
Country	:	US
Telephone Number	:	702-463-5728
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. JEANINE RODRIGUEZ
Credential	:	O.T.R.L
Telephone Number	:	702-463-5728

Provider Enumeration Date	:	04/23/2013
Last Update Date	:	04/23/2013

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