Provider Demographics
NPI:1639275845
Name:ROBINSON, SHALETA MARIE (AUD, CCCA)
Entity Type:Individual
Prefix:DR
First Name:SHALETA
Middle Name:MARIE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:AUD, CCCA
Other - Prefix:DR
Other - First Name:SHALETA
Other - Middle Name:MARIE
Other - Last Name:HICKS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:AUD, CCC-A
Mailing Address - Street 1:2020 N FORBES BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-1415
Mailing Address - Country:US
Mailing Address - Phone:520-770-3200
Mailing Address - Fax:520-770-3782
Practice Address - Street 1:2020 N FORBES BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-1415
Practice Address - Country:US
Practice Address - Phone:520-770-3200
Practice Address - Fax:520-770-3782
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA4248231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist