1760547780 NPI number — MRS. ROBIN DAWN HOLCOMB MA CCC SLP

Table of content: MRS. ROBIN DAWN HOLCOMB MA CCC SLP (NPI 1760547780)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760547780 NPI number — MRS. ROBIN DAWN HOLCOMB MA CCC SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOLCOMB
Provider First Name:
ROBIN
Provider Middle Name:
DAWN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MA CCC SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BELANGER
Provider Other First Name:
ROBIN
Provider Other Middle Name:
DAWN
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
MA CCC SLP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1760547780
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5 ESTHER AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH ATTLEBORO
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02760
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-386-5240
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
SOUTH BAY EARLY INTERVENTION
Provider Second Line Business Practice Location Address:
1115 WEST CHESTNUT ST
Provider Business Practice Location Address City Name:
BROCKTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-559-0473
Provider Business Practice Location Address Fax Number:
508-427-5361
Provider Enumeration Date:
12/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  6630 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 235Z00000X , with the licence number: 12022158 ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com