Provider Demographics
NPI:1194053983
Name:CAVICCHI, ROBIN BETH (MS,CCC-SLP)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:BETH
Last Name:CAVICCHI
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 EAST ST
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02048-3411
Mailing Address - Country:US
Mailing Address - Phone:508-944-0824
Mailing Address - Fax:
Practice Address - Street 1:1105 EAST ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:MA
Practice Address - Zip Code:02048-3411
Practice Address - Country:US
Practice Address - Phone:508-944-0824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-07
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4150235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist