| Doctor Name: | ROBIN CARLISLE |
| NPI Number: | 1164892022 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SLP |
| License Number: | S0554 |
| Business Practice Address: | 213 Allen Dr Brandon, MS - 390474617 |
| Business Phone Number: | 6016678414 |
| Business Fax Number: | 8884088272 |
| Mailing Address: | Po Box 4129, BRANDON |
| State: | MS |
| Postal Code: | 390474129 |
| Phone Number: | 6019273795 |
| Fax Number: | 8884088272 |
| NPI Enumeration Date: | 10/04/2015 |
| NPI Last Update Date: | 10/04/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | S0554 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |