Provider Demographics
NPI:1497360317
Name:BRADY, ROBYN ELOUISE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:ELOUISE
Last Name:BRADY
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:ROBYN
Other - Middle Name:ELOUISE
Other - Last Name:CAIRNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:1829 N GRAND
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85201-1706
Mailing Address - Country:US
Mailing Address - Phone:480-472-5000
Mailing Address - Fax:
Practice Address - Street 1:1829 N GRAND
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85201-1706
Practice Address - Country:US
Practice Address - Phone:480-472-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-09
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP13145235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist