Provider Demographics
NPI:1164454559
Name:DEVANE, ROBIN L (AUDIOLOGY ASSISTANT)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:L
Last Name:DEVANE
Suffix:
Gender:F
Credentials:AUDIOLOGY ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 E BELLA VISTA ST
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805
Mailing Address - Country:US
Mailing Address - Phone:863-686-3189
Mailing Address - Fax:863-682-1348
Practice Address - Street 1:710 E BELLA VISTA ST
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805
Practice Address - Country:US
Practice Address - Phone:863-686-3189
Practice Address - Fax:863-682-1348
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAI622355A2700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355A2700XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistAudiology Assistant