Provider Demographics
NPI:1043044928
Name:ROBINSON, QUADEIRA RENEE SMITH (COTA/L)
Entity type:Individual
Prefix:
First Name:QUADEIRA
Middle Name:RENEE SMITH
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 GREEN HAVEN DR
Mailing Address - Street 2:
Mailing Address - City:ROCKWELL
Mailing Address - State:NC
Mailing Address - Zip Code:28138-8924
Mailing Address - Country:US
Mailing Address - Phone:980-234-1066
Mailing Address - Fax:
Practice Address - Street 1:130 GREEN HAVEN DR
Practice Address - Street 2:
Practice Address - City:ROCKWELL
Practice Address - State:NC
Practice Address - Zip Code:28138-8924
Practice Address - Country:US
Practice Address - Phone:980-234-1066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-31
Last Update Date:2024-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15236224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant