Provider Demographics
NPI:1609988013
Name:NORTON, ROBIN KELLOGG
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:KELLOGG
Last Name:NORTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 ASHLAND CT
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-2857
Mailing Address - Country:US
Mailing Address - Phone:816-364-4502
Mailing Address - Fax:
Practice Address - Street 1:3303 FREDERICK AVE
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-2985
Practice Address - Country:US
Practice Address - Phone:816-364-3836
Practice Address - Fax:816-390-8546
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO00993235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO13375022OtherBLUE CROSS/BLUE SHIELD