Provider Demographics
NPI:1487218020
Name:ROBBINS, LISA L (SLPA)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:L
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11005 W ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85323-6898
Mailing Address - Country:US
Mailing Address - Phone:714-860-0022
Mailing Address - Fax:
Practice Address - Street 1:11005 W ADAMS ST
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85323-6898
Practice Address - Country:US
Practice Address - Phone:714-860-0022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-29
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA116922355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant