Provider Demographics
NPI:1164543955
Name:HOLCOMB, ROBIN LYNN (MED CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:LYNN
Last Name:HOLCOMB
Suffix:
Gender:F
Credentials:MED CCC-SLP
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:LYNN
Other - Last Name:SAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1105 S MORGAN DR
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-7023
Mailing Address - Country:US
Mailing Address - Phone:405-794-0882
Mailing Address - Fax:
Practice Address - Street 1:6400 N SANTA FE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-9126
Practice Address - Country:US
Practice Address - Phone:405-840-2903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2761235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist