Provider Demographics
NPI:1417389552
Name:PAULIVE, ROBIN (MS,CCC, SLP)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:
Last Name:PAULIVE
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 1:20960 SHADY VISTA LN
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-1152
Mailing Address - Country:US
Mailing Address - Phone:561-251-6627
Mailing Address - Fax:
Practice Address - Street 1:20960 SHADY VISTA LN
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-1152
Practice Address - Country:US
Practice Address - Phone:561-251-6627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-31
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA1416235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist