Provider Demographics
NPI:1588030928
Name:SELMAN, ROBIN (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:SELMAN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-4017
Mailing Address - Country:US
Mailing Address - Phone:972-523-9335
Mailing Address - Fax:
Practice Address - Street 1:202 WILLOW ST
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-4017
Practice Address - Country:US
Practice Address - Phone:972-523-9335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-20
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP008798235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GASLP008798OtherSTATE LICENSE