Provider Demographics
NPI:1730372749
Name:ROBERTSON, PANAGIOTA CHRISTOU (OTR)
Entity type:Individual
Prefix:MRS
First Name:PANAGIOTA
Middle Name:CHRISTOU
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4303 DUBARRY RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46226-5333
Mailing Address - Country:US
Mailing Address - Phone:317-416-4192
Mailing Address - Fax:317-543-2684
Practice Address - Street 1:4303 DUBARRY RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46226-5333
Practice Address - Country:US
Practice Address - Phone:317-416-4192
Practice Address - Fax:317-543-2684
Is Sole Proprietor?:No
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31004167A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist