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NPI 1487887899

NPI 1487887899 : KERRI LEANNE ROBERSON M.S., CCC-SLP : LUBBOCK, TX

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General NPI Number Information
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    NPI Number           |    1487887899
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    Entity Type          |    Individual 
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    Provider Name        |    KERRI LEANNE ROBERSON M.S., CCC-SLP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/01/2009
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    Last Update Date     |    09/01/2009
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Provider Practice Location Address
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    Address Line         |    8207 HUDSON AVE STE A 
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    City                 |    LUBBOCK
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    State                |    TX
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    Zip                  |    79423-2805
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    Country              |    US
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    Telephone            |    806-792-6135
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    Fax                  |    806-792-4945
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Provider Business Mailing Address
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    Address Line         |    7903 JOLIET AVE 
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    City                 |    LUBBOCK
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    State                |    TX
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    Zip                  |    79423-1719
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    Country              |    US
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    Telephone            |    806-780-3218
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    235Z00000X
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    Taxonomy Name        |    Speech-Language Pathologist
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    License Number       |    15333
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    License Number State |    TX
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