Healthcare Provider Details

I. General information

NPI: 1669133294
Provider Name (Legal Business Name): AUSTIN DANIEL ERDMAN MA, SLP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2022
Last Update Date: 01/05/2022
Certification Date: 01/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 E STATE ST
BELDING MI
48809-2200
US

IV. Provider business mailing address

1944 BUTTRICK AVE SE
ADA MI
49301-9204
US

V. Phone/Fax

Practice location:
  • Phone: 616-794-0460
  • Fax:
Mailing address:
  • Phone: 616-745-7346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: