Provider Demographics
NPI:1861216665
Name:ROBINSON, TITA T
Entity type:Individual
Prefix:
First Name:TITA
Middle Name:T
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 1:10931 E INDEPENDENCE BLVD STE D-2
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-5058
Mailing Address - Country:US
Mailing Address - Phone:980-327-4760
Mailing Address - Fax:
Practice Address - Street 1:10931 E INDEPENDENCE BLVD STE D-2
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5058
Practice Address - Country:US
Practice Address - Phone:980-327-4760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-09
Last Update Date:2024-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health