Provider Demographics
NPI:1487021416
Name:WESSELS, ROBYN
Entity Type:Individual
Prefix:MS
First Name:ROBYN
Middle Name:
Last Name:WESSELS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 SCOTT ST
Mailing Address - Street 2:UNIT 5
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202-3824
Mailing Address - Country:US
Mailing Address - Phone:215-209-9646
Mailing Address - Fax:
Practice Address - Street 1:333 EXECUTIVE CT
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-4550
Practice Address - Country:US
Practice Address - Phone:501-526-8770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-25
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist