Provider Demographics
NPI:1689345787
Name:HODGES-ROBINSON, NIBRA (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:NIBRA
Middle Name:
Last Name:HODGES-ROBINSON
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:NIBRA
Other - Middle Name:
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:1612 EBENEZER RD STE 101
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-3862
Mailing Address - Country:US
Mailing Address - Phone:803-329-9500
Mailing Address - Fax:
Practice Address - Street 1:1612 EBENEZER RD STE 101
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-3862
Practice Address - Country:US
Practice Address - Phone:803-329-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-28
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist