| Doctor Name: | ROBERTA OLOUGHLIN |
| NPI Number: | 1205206018 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 075256 |
| Business Practice Address: | 905 Montgomery St Decorah, IA - 521012325 |
| Business Phone Number: | 5633823649 |
| Business Fax Number: | 5633828183 |
| Mailing Address: | 905 Montgomery St, DECORAH |
| State: | IA |
| Postal Code: | 521012325 |
| Phone Number: | 5633823649 |
| Fax Number: | 5633828183 |
| NPI Enumeration Date: | 10/06/2015 |
| NPI Last Update Date: | 11/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0808X |
| License Number: | 075256 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |