=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598872590
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHILDHOOD LANG CNTR AT RICH. INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/24/2006
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4202 HERMITAGE RD
-----------------------------------------------------
City | RICHMOND
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23227-3755
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 804-266-6699
-----------------------------------------------------
Fax | 804-264-5988
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4202 HERMITAGE RD
-----------------------------------------------------
City | RICHMOND
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23227-3755
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 804-266-6699
-----------------------------------------------------
Fax | 804-264-5988
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | MRS. ROBIN KAYE OLIVIER
-----------------------------------------------------
Credential | CCC-SLP
-----------------------------------------------------
Telephone | 804-266-6699
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 231H00000X
-----------------------------------------------------
Taxonomy Name | Audiologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------