Provider Demographics
NPI:1679695522
Name:ROBINS, GALE LANDIS (MA CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:GALE
Middle Name:LANDIS
Last Name:ROBINS
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 906
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:NC
Mailing Address - Zip Code:27298-0906
Mailing Address - Country:US
Mailing Address - Phone:336-963-1246
Mailing Address - Fax:336-626-5736
Practice Address - Street 1:613 S. FAYETTEVILLE ST.
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:NC
Practice Address - Zip Code:27298-0906
Practice Address - Country:US
Practice Address - Phone:336-963-1246
Practice Address - Fax:336-626-5736
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6616235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1099QOtherBCBS
NC3403407Medicaid