Provider Demographics
NPI:1982890323
Name:POWELL, ROBYN LEE (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ROBYN
Middle Name:LEE
Last Name:POWELL
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Gender:F
Credentials:MA, CCC-SLP
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Mailing Address - Street 1:500 DISCOVERY DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-3871
Mailing Address - Country:US
Mailing Address - Phone:757-668-2415
Mailing Address - Fax:757-668-2420
Practice Address - Street 1:500 DISCOVERY DR
Practice Address - Street 2:SUITE 201
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-3871
Practice Address - Country:US
Practice Address - Phone:757-668-2415
Practice Address - Fax:757-668-2420
Is Sole Proprietor?:No
Enumeration Date:2007-09-19
Last Update Date:2012-10-12
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Provider Licenses
StateLicense IDTaxonomies
VA2202005362235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004980093Medicaid
VA004980093Medicaid