Healthcare Provider Details

I. General information

NPI: 1073423182
Provider Name (Legal Business Name): ROBIN MARTI SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 W 5TH AVE
BRODHEAD WI
53520-2013
US

IV. Provider business mailing address

704 E 5TH AVE
BRODHEAD WI
53520-1252
US

V. Phone/Fax

Practice location:
  • Phone: 608-897-2146
  • Fax:
Mailing address:
  • Phone: 608-214-3210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number1820
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: