MEDICARE: MRS. ERIKA V ROBINSON

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	SLP006022	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	10034815	OTHER	AMERIGROUP
2	305487	OTHER	WELLCARE
3	251913439	OTHER	AETNA
4	251913439	OTHER	BCBS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	440163644D	OTHER	PEACHSTATE

General Provider Information

NPI Number	:	1548300353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ERIKA V ROBINSON

Provider Business Mailing Address
First Line	:	4979 TADMORE LN
Second Line	:
City	:	LITHONIA
State	:	GA
Zip	:	30038-2237
Country	:	US
Telephone Number	:	404-551-0222
Fax Number	:	770-696-3022

Provider Business Practice Location Address
First Line	:	1835 SAVOY DR
Second Line	:	SUITE 100
City	:	ATLANTA
State	:	GA
Zip	:	30341-1072
Country	:	US
Telephone Number	:	678-298-9484
Fax Number	:	678-826-4033

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

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	06/27/2012

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