Provider Demographics
NPI:1699903203
Name:ROBICHAUD, AMANDA C (CFA)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:C
Last Name:ROBICHAUD
Suffix:
Gender:F
Credentials:CFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4548 S BANNOCK ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110-5706
Mailing Address - Country:US
Mailing Address - Phone:303-929-1090
Mailing Address - Fax:303-781-3627
Practice Address - Street 1:4548 S BANNOCK ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80110-5706
Practice Address - Country:US
Practice Address - Phone:303-929-1090
Practice Address - Fax:303-781-3627
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist