Provider Demographics
NPI:1316111784
Name:ROBINSON, RACHEL E MIKLES (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:E MIKLES
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 1:806 WOOD DUCK LN
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72801-4755
Mailing Address - Country:US
Mailing Address - Phone:479-880-8716
Mailing Address - Fax:479-880-8716
Practice Address - Street 1:806 WOOD DUCK LN
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72801-4755
Practice Address - Country:US
Practice Address - Phone:479-880-8716
Practice Address - Fax:479-880-8716
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-16
Last Update Date:2012-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP1917235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist