Provider Demographics
NPI:1508576794
Name:ROBINSON, GREGORY (PHD CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:PHD CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17209 BUTLER
Mailing Address - Street 2:
Mailing Address - City:ALEXANDER
Mailing Address - State:AR
Mailing Address - Zip Code:72002-9213
Mailing Address - Country:US
Mailing Address - Phone:501-366-9104
Mailing Address - Fax:
Practice Address - Street 1:4021 W 8TH ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-2029
Practice Address - Country:US
Practice Address - Phone:501-526-4487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-29
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2332235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist