MEDICARE: DR. SHALETA MARIE ROBINSON AU.D., CCCA

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	231H00000X	Audiologist	DA4248	AZ

General Provider Information

NPI Number	:	1639275845
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHALETA MARIE ROBINSON AU.D., CCCA

Provider Business Mailing Address
First Line	:	2020 N FORBES BLVD
Second Line	:	SUITE 104
City	:	TUCSON
State	:	AZ
Zip	:	85745-1415
Country	:	US
Telephone Number	:	520-770-3200
Fax Number	:	520-770-3782

Provider Business Practice Location Address
First Line	:	2020 N FORBES BLVD
Second Line	:	SUITE 104
City	:	TUCSON
State	:	AZ
Zip	:	85745-1415
Country	:	US
Telephone Number	:	520-770-3200
Fax Number	:	520-770-3782

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

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	09/20/2007

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