MEDICARE: MRS. ROBIN J KELLER MS, SLP/CCC

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	114180	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538484365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ROBIN J KELLER MS, SLP/CCC

Provider Business Mailing Address
First Line	:	1000 SAINT LOUIS AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-3366
Country	:	US
Telephone Number	:	817-921-5020
Fax Number	:	817-921-5022

Provider Business Practice Location Address
First Line	:	1000 SAINT LOUIS AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-3366
Country	:	US
Telephone Number	:	817-921-5020
Fax Number	:	817-921-5022

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

Provider Enumeration Date	:	04/05/2010
Last Update Date	:	09/26/2022

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Directions to “ MRS. ROBIN J KELLER MS, SLP/CCC” Practice Location

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