Provider Demographics
NPI:1710485545
Name:MILAM, ROBINSON D
Entity Type:Individual
Prefix:
First Name:ROBINSON
Middle Name:D
Last Name:MILAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2813 IRISDALE AVE
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23228-5565
Mailing Address - Country:US
Mailing Address - Phone:804-363-9253
Mailing Address - Fax:
Practice Address - Street 1:8320 BUFFIN RD
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23231-7438
Practice Address - Country:US
Practice Address - Phone:804-795-7020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-26
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202003251235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist