Provider Demographics
NPI:1619167343
Name:ROBERTS, RITA ANN (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:ANN
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:RITA
Other - Middle Name:ANN
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:1662 STRINGER RD
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:SC
Mailing Address - Zip Code:29627-9710
Mailing Address - Country:US
Mailing Address - Phone:864-462-0017
Mailing Address - Fax:
Practice Address - Street 1:2203 MARCHBANKS AVE
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-2247
Practice Address - Country:US
Practice Address - Phone:864-437-8898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV0460235Z00000X
SC5121235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist