Provider Demographics
NPI:1770878829
Name:ROBINSON, KAMBRIA (MS, TSLP)
Entity type:Individual
Prefix:MRS
First Name:KAMBRIA
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MS, TSLP
Other - Prefix:MISS
Other - First Name:KAMBRIA
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2116 E VAUGHN AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-6213
Mailing Address - Country:US
Mailing Address - Phone:480-628-1853
Mailing Address - Fax:
Practice Address - Street 1:1749 E CABORCA DR
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-6382
Practice Address - Country:US
Practice Address - Phone:520-280-1825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-16
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTSLP7356235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist