Provider Demographics
NPI:1730554270
Name:ROBINSON, LYDIA (LAT, ATC)
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 BAYOU VIEW DR
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:LA
Mailing Address - Zip Code:70514-1415
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:324 BAYOU VIEW DR
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:LA
Practice Address - Zip Code:70514-1415
Practice Address - Country:US
Practice Address - Phone:337-578-5570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-09
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAATH.2002262255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer