Provider Demographics
NPI:1528273323
Name:SMITH, ROBLYN THOMPSON
Entity type:Individual
Prefix:
First Name:ROBLYN
Middle Name:THOMPSON
Last Name:SMITH
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 1:130 MAPLE LEAF AVE
Mailing Address - Street 2:
Mailing Address - City:SILOAM SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72761-5562
Mailing Address - Country:US
Mailing Address - Phone:479-549-4004
Mailing Address - Fax:
Practice Address - Street 1:1103 W EMMA AVE
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72764-4103
Practice Address - Country:US
Practice Address - Phone:479-750-8832
Practice Address - Fax:479-750-8811
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#1734235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist