Provider Demographics
NPI:1326230863
Name:MIRANTE, ROBIN A (MS CCC/SLP)
Entity type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:A
Last Name:MIRANTE
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 1:241 RHODE ISLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:RI
Mailing Address - Zip Code:02871-5712
Mailing Address - Country:US
Mailing Address - Phone:401-480-2618
Mailing Address - Fax:
Practice Address - Street 1:275 CAMBRIDGE ST
Practice Address - Street 2:PROFESSIONAL OFFICE BLDG. 3RD FLOOR
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3108
Practice Address - Country:US
Practice Address - Phone:617-724-0765
Practice Address - Fax:617-724-0771
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4193235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist