Provider Demographics
NPI:1992096424
Name:MANDELBAUM, ROBYN (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ROBYN
Middle Name:
Last Name:MANDELBAUM
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 1:2301 E ST NW
Mailing Address - Street 2:A1101
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-2829
Mailing Address - Country:US
Mailing Address - Phone:202-776-0057
Mailing Address - Fax:
Practice Address - Street 1:2301 E ST NW
Practice Address - Street 2:A1101
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-2829
Practice Address - Country:US
Practice Address - Phone:202-776-0057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-02
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202004155235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist