Provider Demographics
NPI:1528341658
Name:ROBBINS, BRIANNA DIANE (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:BRIANNA
Middle Name:DIANE
Last Name:ROBBINS
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 1:4 FLORIDA DR
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04062-5492
Mailing Address - Country:US
Mailing Address - Phone:207-222-1346
Mailing Address - Fax:
Practice Address - Street 1:106 WEEKS RD
Practice Address - Street 2:
Practice Address - City:GORHAM
Practice Address - State:ME
Practice Address - Zip Code:04038-1607
Practice Address - Country:US
Practice Address - Phone:207-222-1346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP1547235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MESP1547OtherMAINE STATE LICENSURE - SPEECH LANGUAGE PATHOLOGY