Provider Demographics
NPI:1760001226
Name:MANLEY, ROBIN LYNN WILSON (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:LYNN WILSON
Last Name:MANLEY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4233 MARBLE RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-2876
Mailing Address - Country:US
Mailing Address - Phone:859-583-6141
Mailing Address - Fax:
Practice Address - Street 1:4233 MARBLE RIDGE LN
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-2876
Practice Address - Country:US
Practice Address - Phone:859-583-6141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-14
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH21782801235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist