Healthcare Provider Details

I. General information

NPI: 1851121719
Provider Name (Legal Business Name): ERIN LECHEMINANT CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2024
Last Update Date: 08/06/2024
Certification Date: 08/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7060 CAMP BOWIE BLVD
FORT WORTH TX
76116-7119
US

IV. Provider business mailing address

10194 MEADOWCREST DR
BENBROOK TX
76126-9510
US

V. Phone/Fax

Practice location:
  • Phone: 817-814-2000
  • Fax:
Mailing address:
  • Phone: 614-937-3029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number122144
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: