Provider Demographics
NPI:1487028593
Name:THAMES, ROBIN KENNEDY (MCD, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:KENNEDY
Last Name:THAMES
Suffix:
Gender:F
Credentials:MCD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1614 ASHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36066-3627
Mailing Address - Country:US
Mailing Address - Phone:334-224-3397
Mailing Address - Fax:
Practice Address - Street 1:1614 ASHWOOD DR
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36066-3627
Practice Address - Country:US
Practice Address - Phone:334-224-3397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-01
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3833235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist