Provider Demographics
NPI:1790667152
Name:HIBBARD, ROBIN (MED-CCC-SLP)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:HIBBARD
Suffix:
Gender:F
Credentials:MED-CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15520 WOOD CREEK LN
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-9706
Mailing Address - Country:US
Mailing Address - Phone:405-306-6035
Mailing Address - Fax:
Practice Address - Street 1:15520 WOOD CREEK LN
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-9706
Practice Address - Country:US
Practice Address - Phone:405-306-6035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2564235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist