Provider Demographics
NPI:1275730962
Name:ROBERTSHAW, HOPE ANN (MA, CCCSLP 14410)
Entity Type:Individual
Prefix:MS
First Name:HOPE
Middle Name:ANN
Last Name:ROBERTSHAW
Suffix:
Gender:F
Credentials:MA, CCCSLP 14410
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4744 LA CRESCENTA AVE
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-2937
Mailing Address - Country:US
Mailing Address - Phone:818-249-4774
Mailing Address - Fax:
Practice Address - Street 1:13400 RIVERSIDE DR
Practice Address - Street 2:SUITE 208
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-2500
Practice Address - Country:US
Practice Address - Phone:818-783-5168
Practice Address - Fax:515-783-6176
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASLP 14410235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist