Provider Demographics
NPI:1275837197
Name:ROBINSON, JENNIFER MICHELLE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MICHELLE
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 1:4431 HOLLAND AVE
Mailing Address - Street 2:APT. C
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-2134
Mailing Address - Country:US
Mailing Address - Phone:832-498-3895
Mailing Address - Fax:
Practice Address - Street 1:4431 HOLLAND AVE
Practice Address - Street 2:APT. C
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-2134
Practice Address - Country:US
Practice Address - Phone:832-498-3895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-06
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104379235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist