Provider Demographics
NPI:1164550158
Name:ONEIL, ROBIN MICHELLE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:MICHELLE
Last Name:ONEIL
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
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Mailing Address - Street 1:10712 BARDSTOWN WOODS BLVD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40291-3377
Mailing Address - Country:US
Mailing Address - Phone:502-819-9955
Mailing Address - Fax:502-231-8238
Practice Address - Street 1:111 BONNIE LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-3207
Practice Address - Country:US
Practice Address - Phone:502-671-1787
Practice Address - Fax:502-231-8238
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-2514235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist