Provider Demographics
NPI:1790016053
Name:ROBINSON, ALTHEA BROWN
Entity Type:Individual
Prefix:
First Name:ALTHEA
Middle Name:BROWN
Last Name:ROBINSON
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 1:1025 LAKE FRANCES DR
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056-8316
Mailing Address - Country:US
Mailing Address - Phone:504-453-6622
Mailing Address - Fax:
Practice Address - Street 1:1025 LAKE FRANCES DR
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-8316
Practice Address - Country:US
Practice Address - Phone:504-453-6622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA872235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist