Provider Demographics
NPI:1710334099
Name:MIGLIORINI, ROBYN ASHLEY (PHD)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:ASHLEY
Last Name:MIGLIORINI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 NW WALL ST STE 303
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-1970
Mailing Address - Country:US
Mailing Address - Phone:781-288-5141
Mailing Address - Fax:541-797-6471
Practice Address - Street 1:1345 NW WALL ST STE 303
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-1970
Practice Address - Country:US
Practice Address - Phone:781-288-5141
Practice Address - Fax:541-797-6471
Is Sole Proprietor?:No
Enumeration Date:2016-05-17
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3051103TC0700X
103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical