Provider Demographics
NPI:1407984537
Name:ROBINSON, SAMANTHA RENE (MED CCC SLP)
Entity Type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:RENE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MED CCC SLP
Other - Prefix:MS
Other - First Name:SAMANTHA
Other - Middle Name:RENE
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MED CCC SLP
Mailing Address - Street 1:5412 STEEPLE CHASE RD
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANA
Mailing Address - State:TN
Mailing Address - Zip Code:37037
Mailing Address - Country:US
Mailing Address - Phone:615-896-7280
Mailing Address - Fax:
Practice Address - Street 1:825 FISHER AVE
Practice Address - Street 2:
Practice Address - City:SMITHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37166
Practice Address - Country:US
Practice Address - Phone:615-597-4284
Practice Address - Fax:615-597-0739
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN1140235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist