Provider Demographics
NPI:1982141909
Name:CRANE, ROBYN (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:
Last Name:CRANE
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10325 S VANKAL ST
Mailing Address - Street 2:
Mailing Address - City:MATTAWAN
Mailing Address - State:MI
Mailing Address - Zip Code:49071-9438
Mailing Address - Country:US
Mailing Address - Phone:269-743-9999
Mailing Address - Fax:
Practice Address - Street 1:1451 BRONSON WAY
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-3306
Practice Address - Country:US
Practice Address - Phone:269-567-5904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-28
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9712235Z00000X
MI7101005713235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist