Provider Demographics
NPI:1851860456
Name:HEYDARI, ROBYN A
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:A
Last Name:HEYDARI
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 1:466 E GREEN ST
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-5624
Mailing Address - Country:US
Mailing Address - Phone:301-956-5873
Mailing Address - Fax:
Practice Address - Street 1:739 W 5TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-5103
Practice Address - Country:US
Practice Address - Phone:541-514-7997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-13
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor