Provider Demographics
NPI:1215494653
Name:BAYERL, ROBIN KERSEY
Entity type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:KERSEY
Last Name:BAYERL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1809 DIGHTON WAY NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30152-6925
Mailing Address - Country:US
Mailing Address - Phone:770-356-6928
Mailing Address - Fax:
Practice Address - Street 1:1809 DIGHTON WAY NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152-6925
Practice Address - Country:US
Practice Address - Phone:770-356-6928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-21
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency