Healthcare Provider Details

I. General information

NPI: 1407577505
Provider Name (Legal Business Name): ERICA LAYLAND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2022
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9905 S PENNSYLVANIA AVE STE A
OKLAHOMA CITY OK
73159-6920
US

IV. Provider business mailing address

9905 S PENNSYLVANIA AVE STE A
OKLAHOMA CITY OK
73159-6920
US

V. Phone/Fax

Practice location:
  • Phone: 918-409-2713
  • Fax:
Mailing address:
  • Phone: 918-409-2713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number5852
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number14358882
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number116390
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: