Healthcare Provider Details

I. General information

NPI: 1437823184
Provider Name (Legal Business Name): ROBYN OLONA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2021
Last Update Date: 08/05/2021
Certification Date: 08/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 LASER RD NE
RIO RANCHO NM
87124-4517
US

IV. Provider business mailing address

500 LASER RD NE
RIO RANCHO NM
87124-4517
US

V. Phone/Fax

Practice location:
  • Phone: 505-962-1242
  • Fax:
Mailing address:
  • Phone: 505-962-1242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberCF7409
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: