Healthcare Provider Details

I. General information

NPI: 1093099061
Provider Name (Legal Business Name): ERICA Y DOERING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2011
Last Update Date: 12/19/2024
Certification Date: 12/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 N WILLOW ST
HARRISON AR
72601-3518
US

IV. Provider business mailing address

521 N WILLOW ST
HARRISON AR
72601-3518
US

V. Phone/Fax

Practice location:
  • Phone: 417-827-0712
  • Fax: 870-429-1012
Mailing address:
  • Phone:
  • Fax: 870-208-8139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number3965
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: