Healthcare Provider Details

I. General information

NPI: 1528299633
Provider Name (Legal Business Name): ROBYNE M CAUGHRON SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2009
Last Update Date: 08/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 BREMERTON DR
GREENVILLE NC
27858-6548
US

IV. Provider business mailing address

PO BOX 2417
WINTERVILLE NC
28590-2417
US

V. Phone/Fax

Practice location:
  • Phone: 252-327-2244
  • Fax: 252-524-4674
Mailing address:
  • Phone: 252-327-2244
  • Fax: 252-524-4674

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number8551
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: