Provider Demographics
NPI:1679313951
Name:ROBISON, CATHY JO (LMT)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:JO
Last Name:ROBISON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 282
Mailing Address - Street 2:
Mailing Address - City:OJO CALIENTE
Mailing Address - State:NM
Mailing Address - Zip Code:87549-0282
Mailing Address - Country:US
Mailing Address - Phone:505-670-6124
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 452
Practice Address - Street 2:
Practice Address - City:DIXON
Practice Address - State:NM
Practice Address - Zip Code:87527-0452
Practice Address - Country:US
Practice Address - Phone:505-579-9630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-25
Last Update Date:2024-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM6599225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist