Provider Demographics
NPI:1689044661
Name:THORNTON, ROBIN ELIZABETH (EDD, CCC-SLP, FSL)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:ELIZABETH
Last Name:THORNTON
Suffix:
Gender:F
Credentials:EDD, CCC-SLP, FSL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4961 SW 37TH AVE
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-8242
Mailing Address - Country:US
Mailing Address - Phone:305-213-6363
Mailing Address - Fax:
Practice Address - Street 1:4961 SW 37TH AVE
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-8242
Practice Address - Country:US
Practice Address - Phone:305-213-6363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-02
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA1734222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist