Provider Demographics
NPI:1164658068
Name:ROBINSON, CAROL HAYMON (MS, CCC, SLP)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:HAYMON
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MS, CCC, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2023 COUNT CT
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-3286
Mailing Address - Country:US
Mailing Address - Phone:863-513-5119
Mailing Address - Fax:
Practice Address - Street 1:2023 COUNT CT
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-3286
Practice Address - Country:US
Practice Address - Phone:863-513-5119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-05
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 4441235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist