Provider Demographics
NPI:1831391820
Name:ALVERSON, ROBIN PASQUALE (MMS, CCC-A)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:PASQUALE
Last Name:ALVERSON
Suffix:
Gender:F
Credentials:MMS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 HILLCREST PT
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30215-2394
Mailing Address - Country:US
Mailing Address - Phone:770-461-6477
Mailing Address - Fax:
Practice Address - Street 1:33 UPPER RIVERDALE RD SW
Practice Address - Street 2:SUITE 117
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30274-2626
Practice Address - Country:US
Practice Address - Phone:770-991-1170
Practice Address - Fax:770-991-0107
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000854231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist