Provider Demographics
NPI:1316342645
Name:ROBBINS, COLETTE RENE
Entity type:Individual
Prefix:MRS
First Name:COLETTE
Middle Name:RENE
Last Name:ROBBINS
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 1:1810 CYPRUS DR SE
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-8875
Mailing Address - Country:US
Mailing Address - Phone:330-806-4368
Mailing Address - Fax:
Practice Address - Street 1:12000 NAVARRE RD SW
Practice Address - Street 2:
Practice Address - City:NAVARRE
Practice Address - State:OH
Practice Address - Zip Code:44662-9486
Practice Address - Country:US
Practice Address - Phone:330-767-3913
Practice Address - Fax:330-767-4398
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-29
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP-4663235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist