MEDICARE: DEVINA ROBINSON MSOTR/L

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	225C00000X	Rehabilitation Counselor
2	225X00000X	Occupational Therapist	14-0523	NV

General Provider Information

NPI Number	:	1740542760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEVINA ROBINSON MSOTR/L

Provider Business Mailing Address
First Line	:	4855 BOULDER HWY # 2258
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-3012
Country	:	US
Telephone Number	:	702-769-9967
Fax Number	:	702-769-9967

Provider Business Practice Location Address
First Line	:	4855 BOULDER HWY # 2258
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-3012
Country	:	US
Telephone Number	:	702-769-9967
Fax Number	:	702-769-9967

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2012
Last Update Date	:	01/21/2015

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Directions to “ DEVINA ROBINSON MSOTR/L” Practice Location

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