Provider Demographics
NPI:1952927006
Name:ROBINSON, MACIE DEANNE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MACIE
Middle Name:DEANNE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 CRESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-5021
Mailing Address - Country:US
Mailing Address - Phone:304-312-9045
Mailing Address - Fax:304-243-1131
Practice Address - Street 1:222 N 5TH ST STE 201
Practice Address - Street 2:
Practice Address - City:MARTINS FERRY
Practice Address - State:OH
Practice Address - Zip Code:43935-1582
Practice Address - Country:US
Practice Address - Phone:304-243-8310
Practice Address - Fax:304-243-8430
Is Sole Proprietor?:No
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH14337402235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist