Provider Demographics
NPI:1346498102
Name:KISHINEFF, ROBIN (MS, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:KISHINEFF
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:
Other - Last Name:GOLOMBECK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, CCC/SLP
Mailing Address - Street 1:141 N MERAMEC AVE
Mailing Address - Street 2:SUITE 110A
Mailing Address - City:CLAYTON
Mailing Address - State:MO
Mailing Address - Zip Code:63105-3750
Mailing Address - Country:US
Mailing Address - Phone:314-704-5727
Mailing Address - Fax:314-863-7545
Practice Address - Street 1:141 N MERAMEC AVE
Practice Address - Street 2:SUITE 110A
Practice Address - City:CLAYTON
Practice Address - State:MO
Practice Address - Zip Code:63105-3750
Practice Address - Country:US
Practice Address - Phone:314-704-5727
Practice Address - Fax:314-863-7545
Is Sole Proprietor?:No
Enumeration Date:2008-09-05
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003002511235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist