Provider Demographics
NPI:1215083167
Name:SPILKO, ROBIN LYNN (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:LYNN
Last Name:SPILKO
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MRS
Other - First Name:ROBIN
Other - Middle Name:LYNN
Other - Last Name:SPILKO-PRENSKY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:9 TAKATS LN
Mailing Address - Street 2:
Mailing Address - City:SAINT JAMES
Mailing Address - State:NY
Mailing Address - Zip Code:11780-2976
Mailing Address - Country:US
Mailing Address - Phone:631-686-5035
Mailing Address - Fax:
Practice Address - Street 1:9 TAKATS LN
Practice Address - Street 2:
Practice Address - City:SAINT JAMES
Practice Address - State:NY
Practice Address - Zip Code:11780-2976
Practice Address - Country:US
Practice Address - Phone:631-686-5035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008895235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist