Provider Demographics
NPI:1407187222
Name:ROBBINS, NICOLE SPIRES (SLP)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:SPIRES
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 SANDEFUR RD
Mailing Address - Street 2:
Mailing Address - City:KATHLEEN
Mailing Address - State:GA
Mailing Address - Zip Code:31047-2000
Mailing Address - Country:US
Mailing Address - Phone:478-335-5597
Mailing Address - Fax:
Practice Address - Street 1:155 SANDEFUR RD
Practice Address - Street 2:
Practice Address - City:KATHLEEN
Practice Address - State:GA
Practice Address - Zip Code:31047-2000
Practice Address - Country:US
Practice Address - Phone:478-335-5597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-18
Last Update Date:2010-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP003853235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist