Provider Demographics
NPI:1255744991
Name:MACDONALD, ROBIN STRATTON (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:STRATTON
Last Name:MACDONALD
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 1:965 GOLDBELT AVE
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-1633
Mailing Address - Country:US
Mailing Address - Phone:907-789-1303
Mailing Address - Fax:
Practice Address - Street 1:400 W 11TH ST
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-1512
Practice Address - Country:US
Practice Address - Phone:907-321-7132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-10
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK373235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist