Individual
ROBIN H BRAVEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC A
Contact information
Practice address
20 WORCESTER CENTER BLVD, WORCESTER, MA 01608-1312
(508) 368-3103
(508) 368-3104
Mailing address
630 PLANTATION ST, WORCESTER, MA 01605-2038
(508) 368-3103
(508) 368-3104
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
107
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042472266
THREE RIVERS
—
01
—
042472266039
TRICARE CHAMPUS
—
05
—
5104432
—
MA
01
—
54935
FALLON COMMUNITY HEALTH P
—
01
—
7709598
AETNA US HEALTHCARE
—
01
—
AA3615
HARVARD PILGRIM HEALTHCAR
—
01
—
AD0170
BLUE SHIELD INDEMNITY
—
Enumeration date
11/16/2005
Last updated
01/30/2009
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