Healthcare Provider Details

I. General information

NPI: 1366748022
Provider Name (Legal Business Name): ERIN K GEDDES MA, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2011
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 PUNTA LINDA
SANDIA PARK NM
87047-9678
US

IV. Provider business mailing address

23 PUNTA LINDA
SANDIA PARK NM
87047-9678
US

V. Phone/Fax

Practice location:
  • Phone: 720-560-1017
  • Fax:
Mailing address:
  • Phone: 720-560-1017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSAH-2024-0035
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number01121041
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: