Robert Hinman, COTA

Individual provider Active NPI Occupational Therapy Assistant · Placitas, NM

NPI 1780004077 · NPPES record last updated Apr 24, 2014

Key facts

NPI
1780004077
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
212607 (TX)
Practice address
14 Puesta del Sol
Placitas, NM 87043-8825
Phone
(505) 615-1453
NPI assigned
Apr 24, 2014
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
212607TXMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 212607 TX Yes

Addresses

Primary practice location

14 Puesta del Sol
Placitas, NM 87043-8825

Mailing address

14 Puesta del Sol
Placitas, NM 87043-8825

Other identifiers

IdentifierTypeStateIssuer
3824880776MedicaidNM

Other providers in Placitas, NM

All providers in Placitas, NM · Occupational Therapy Assistant in New Mexico

Sources for this page

Verify at the official NPI Registry.