Healthcare Provider Details

I. General information

NPI: 1720915150
Provider Name (Legal Business Name): ROSLYNN NYANHONGO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1311 CHISHOLM TRAIL RD STE 506
ROUND ROCK TX
78681-2970
US

IV. Provider business mailing address

117 FIERY SKIPPER LN
GEORGETOWN TX
78626-3012
US

V. Phone/Fax

Practice location:
  • Phone: 512-677-9345
  • Fax:
Mailing address:
  • Phone: 512-541-5280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number92342
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: