Provider Demographics
NPI:1740436765
Name:BALTZ, ROBIN DIANA (MCD,CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:DIANA
Last Name:BALTZ
Suffix:
Gender:F
Credentials:MCD,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 W ELM ST
Mailing Address - Street 2:
Mailing Address - City:WALNUT RIDGE
Mailing Address - State:AR
Mailing Address - Zip Code:72476-1839
Mailing Address - Country:US
Mailing Address - Phone:870-886-7873
Mailing Address - Fax:
Practice Address - Street 1:508 E FREE ST
Practice Address - Street 2:
Practice Address - City:WALNUT RIDGE
Practice Address - State:AR
Practice Address - Zip Code:72476-2804
Practice Address - Country:US
Practice Address - Phone:870-886-3482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-10
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#1745235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist