Healthcare Provider Details

I. General information

NPI: 1316776198
Provider Name (Legal Business Name): DALISHA DONYALE ROBINSON NCPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2024
Last Update Date: 08/16/2024
Certification Date: 08/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 N HULLEN ST STE 109
METAIRIE LA
70002-5900
US

IV. Provider business mailing address

2601 N HULLEN ST STE 109
METAIRIE LA
70002-5900
US

V. Phone/Fax

Practice location:
  • Phone: 888-763-3522
  • Fax:
Mailing address:
  • Phone: 504-388-2080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number24R-1666
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: