Provider Demographics
NPI:1538372016
Name:ROBINSON, LACEY LYNNE
Entity type:Individual
Prefix:
First Name:LACEY
Middle Name:LYNNE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11354 MAINSAIL CT
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-9150
Mailing Address - Country:US
Mailing Address - Phone:317-863-2751
Mailing Address - Fax:
Practice Address - Street 1:11354 MAINSAIL CT
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-9150
Practice Address - Country:US
Practice Address - Phone:317-863-2751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist