Provider Demographics
NPI:1508573882
Name:ROBERTSON, KENYA (MS L-SLP, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KENYA
Middle Name:
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:MS L-SLP, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12301 MORRISON RD
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70128-4508
Mailing Address - Country:US
Mailing Address - Phone:504-782-8618
Mailing Address - Fax:
Practice Address - Street 1:12301 MORRISON RD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70128-4508
Practice Address - Country:US
Practice Address - Phone:504-782-8618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-04
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4132235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist