Provider Demographics
NPI:1861946493
Name:GILBERT, ROBERT LEE II (COTA-L)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:LEE
Last Name:GILBERT
Suffix:II
Gender:M
Credentials:COTA-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:303 BENCHMARK DR
Mailing Address - Street 2:
Mailing Address - City:EVINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24550-3763
Mailing Address - Country:US
Mailing Address - Phone:434-426-5885
Mailing Address - Fax:
Practice Address - Street 1:303 BENCHMARK DR
Practice Address - Street 2:
Practice Address - City:EVINGTON
Practice Address - State:VA
Practice Address - Zip Code:24550-3763
Practice Address - Country:US
Practice Address - Phone:434-426-5885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-11
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0131001623224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant