Basic Information
| Provider Information | |||||||||
| NPI: | 1174583652 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RITCHEY | ||||||||
| FirstName: | ROBYN | ||||||||
| MiddleName: | LYNN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MA CCC-A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 834 W 4TH ST | ||||||||
| Address2: | |||||||||
| City: | WATERLOO | ||||||||
| State: | IA | ||||||||
| PostalCode: | 50702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3192344360 | ||||||||
| FaxNumber: | 3192725825 | ||||||||
| Practice Location | |||||||||
| Address1: | 2310 ST FRANCIS DR | ||||||||
| Address2: | SUITE 411 | ||||||||
| City: | WATERLOO | ||||||||
| State: | IA | ||||||||
| PostalCode: | 50702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3192725816 | ||||||||
| FaxNumber: | 3192725825 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2006 | ||||||||
| LastUpdateDate: | 01/09/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 00535 | IA | Y | Speech, Language and Hearing Service Providers | Audiologist | 237700000X | 00824 | IA | N | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
ID Information
| ID | Type | State | Issuer | Description | 0457788 | 05 | IA | MEDICAID |