MEDICARE: JENNIFER MICHELLE ROBINSON M.S, CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	104379	TX

General Provider Information

NPI Number	:	1275837197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER MICHELLE ROBINSON M.S, CCC-SLP

Provider Business Mailing Address
First Line	:	4431 HOLLAND AVE
Second Line	:	APT. C
City	:	DALLAS
State	:	TX
Zip	:	75219-2134
Country	:	US
Telephone Number	:	832-498-3895
Fax Number	:

Provider Business Practice Location Address
First Line	:	4431 HOLLAND AVE
Second Line	:	APT. C
City	:	DALLAS
State	:	TX
Zip	:	75219-2134
Country	:	US
Telephone Number	:	832-498-3895
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2011
Last Update Date	:	08/29/2013

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Directions to “ JENNIFER MICHELLE ROBINSON M.S, CCC-SLP” Practice Location

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