Provider Demographics
NPI:1629387949
Name:BORRESON, ROBYN (MA CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:ROBYN
Middle Name:
Last Name:BORRESON
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 1:1001 LAURENCE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49202-2978
Mailing Address - Country:US
Mailing Address - Phone:517-750-4777
Mailing Address - Fax:517-782-4717
Practice Address - Street 1:1001 LAURENCE AVE STE B
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49202-2978
Practice Address - Country:US
Practice Address - Phone:517-750-4777
Practice Address - Fax:517-782-4717
Is Sole Proprietor?:No
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist