Healthcare Provider Details

I. General information

NPI: 1801098728
Provider Name (Legal Business Name): ERIN KATHERINE MARVIN CFY-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

982 EASTERN PKWY
LOUISVILLE KY
40217-1566
US

IV. Provider business mailing address

982 EASTERN PKWY
LOUISVILLE KY
40217-1566
US

V. Phone/Fax

Practice location:
  • Phone: 502-595-4459
  • Fax: 502-595-3403
Mailing address:
  • Phone: 502-595-4459
  • Fax: 502-595-3403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number07-046
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: