Provider Demographics
NPI:1679632822
Name:ROBERTSON, JAMES B (AUD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:B
Last Name:ROBERTSON
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 BLUEBELL DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-3726
Mailing Address - Country:US
Mailing Address - Phone:717-216-8905
Mailing Address - Fax:717-216-8905
Practice Address - Street 1:117 BLUEBELL DR
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-3726
Practice Address - Country:US
Practice Address - Phone:717-216-8905
Practice Address - Fax:717-216-8905
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT000022L231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist