Provider Demographics
NPI:1619014313
Name:GOLDRING, ROBIN GRAY (MS,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:GRAY
Last Name:GOLDRING
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3050 ROYAL BLVD S STE 105
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-4484
Mailing Address - Country:US
Mailing Address - Phone:678-960-9634
Mailing Address - Fax:678-960-9634
Practice Address - Street 1:3050 ROYAL BLVD S STE 105
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-4484
Practice Address - Country:US
Practice Address - Phone:678-960-9634
Practice Address - Fax:678-960-9634
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP001989235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000963674DMedicaid