Provider Demographics
NPI:1679906457
Name:VASSEY, ROBIN
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:VASSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 GRACERN RD
Mailing Address - Street 2:SUITE 450
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29210-7655
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:720 GRACERN RD
Practice Address - Street 2:SUITE 450
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29210-7655
Practice Address - Country:US
Practice Address - Phone:803-929-1112
Practice Address - Fax:803-929-1418
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-15
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC53052355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant