Provider Demographics
NPI:1477567568
Name:KORNMULLER, ROBIN ANNE (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:ANNE
Last Name:KORNMULLER
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MISS
Other - First Name:ROBIN
Other - Middle Name:ANNE
Other - Last Name:THRIFT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:325E KENNEDY MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-4531
Mailing Address - Country:US
Mailing Address - Phone:207-877-2498
Mailing Address - Fax:
Practice Address - Street 1:325E KENNEDY MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-4531
Practice Address - Country:US
Practice Address - Phone:207-877-2498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RISP00771235Z00000X
MESP3041235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist