Provider Demographics
NPI:1720454176
Name:ROBINSON, RANDALL ALAN (BC-HIS)
Entity Type:Individual
Prefix:MR
First Name:RANDALL
Middle Name:ALAN
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 POOL STREET
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005
Mailing Address - Country:US
Mailing Address - Phone:207-309-9001
Mailing Address - Fax:
Practice Address - Street 1:180 POOL STREET
Practice Address - Street 2:SUITE 104
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005
Practice Address - Country:US
Practice Address - Phone:207-309-9001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-19
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA174237700000X
NHH641237700000X
RI246237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist