Robert Maxwell, M.A., CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Appomattox, VA

NPI 1679698682 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1679698682
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
2202005198 (VA)
Practice address
176 Highland Ave.
Appomattox, VA 24522
Phone
(434) 352-8649
NPI assigned
Mar 20, 2007
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2202005198VAMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2202005198 VA Yes

Addresses

Primary practice location

176 Highland Ave.
Appomattox, VA 24522

Mailing address

176 Highland Ave.
Appomattox, VA 24522
Phone (434) 352-8649

Other providers in Appomattox, VA

All providers in Appomattox, VA · Speech-Language Pathologist in Virginia

Sources for this page

Verify at the official NPI Registry.