Provider Demographics
NPI:1407498132
Name:ROBINSON, MELISA JENNIFER (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MELISA
Middle Name:JENNIFER
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:MELISA
Other - Middle Name:
Other - Last Name:YAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA CCC-SLP
Mailing Address - Street 1:7 ALAN ST
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-5801
Mailing Address - Country:US
Mailing Address - Phone:973-568-4400
Mailing Address - Fax:
Practice Address - Street 1:7 ALAN ST
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-5801
Practice Address - Country:US
Practice Address - Phone:973-568-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-15
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00897600235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist