Provider Demographics
NPI:1245366764
Name:VELDMAN, ROBIN A (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:A
Last Name:VELDMAN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2305 FALLS RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-1109
Mailing Address - Country:US
Mailing Address - Phone:919-418-9883
Mailing Address - Fax:
Practice Address - Street 1:103 BRADY CT STE A
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-4574
Practice Address - Country:US
Practice Address - Phone:919-418-9883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5955235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7412351Medicaid