Provider Demographics
NPI:1487183562
Name:ROBERTSON, MARGARET S (AU D)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:S
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:AU D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4318 E NORTH ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-2425
Mailing Address - Country:US
Mailing Address - Phone:864-655-8300
Mailing Address - Fax:864-603-1555
Practice Address - Street 1:4318 E NORTH ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-2425
Practice Address - Country:US
Practice Address - Phone:864-655-8300
Practice Address - Fax:864-603-1555
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4068231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC4068OtherBOARD OF EXAMINARS IN SPEECH-LANGUAGE PATHOLOGY & AUDIOLOGY