Provider Demographics
NPI:1225174972
Name:KAISER, ROBYN MAE
Entity Type:Individual
Prefix:MS
First Name:ROBYN
Middle Name:MAE
Last Name:KAISER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:452 E SILVERADO RANCH BLVD
Mailing Address - Street 2:#455
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89183-6290
Mailing Address - Country:US
Mailing Address - Phone:702-236-5053
Mailing Address - Fax:702-341-0402
Practice Address - Street 1:452 E SILVERADO RANCH BLVD
Practice Address - Street 2:#455
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89183-6290
Practice Address - Country:US
Practice Address - Phone:702-236-5053
Practice Address - Fax:702-341-0402
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV124225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV003402001Medicaid