Provider Demographics
NPI:1073831400
Name:KOLODZIEJ, ROBYN MARIE (MED RBT)
Entity Type:Individual
Prefix:MRS
First Name:ROBYN
Middle Name:MARIE
Last Name:KOLODZIEJ
Suffix:
Gender:F
Credentials:MED RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14309 TEASDALE AVE
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-8582
Mailing Address - Country:US
Mailing Address - Phone:978-210-7998
Mailing Address - Fax:844-220-9322
Practice Address - Street 1:3100 75TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-2326
Practice Address - Country:US
Practice Address - Phone:727-345-9111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-10
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-17-41692106S00000X
172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician