Provider Demographics
NPI:1548512957
Name:ROBISON, JILL KATHRYN (OTA/L)
Entity type:Individual
Prefix:MISS
First Name:JILL
Middle Name:KATHRYN
Last Name:ROBISON
Suffix:
Gender:F
Credentials:OTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3965 W. 83RD STREET
Mailing Address - Street 2:SUITE 233
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208
Mailing Address - Country:US
Mailing Address - Phone:913-789-9170
Mailing Address - Fax:913-789-9170
Practice Address - Street 1:7819 CONSER PL
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66204
Practice Address - Country:US
Practice Address - Phone:913-789-9170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-09
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS18-00257103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation