Provider Demographics
NPI:1235772583
Name:DYE, ROBIN MICHELLE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:MICHELLE
Last Name:DYE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11449 CENTRAL CT UNIT 106
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-4119
Mailing Address - Country:US
Mailing Address - Phone:720-234-1503
Mailing Address - Fax:
Practice Address - Street 1:4240 KIPLING ST STE F
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-2857
Practice Address - Country:US
Practice Address - Phone:720-234-1503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-18
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0015006225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist