Healthcare Provider Details

I. General information

NPI: 1194020941
Provider Name (Legal Business Name): ERICA M HUFFMAN M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2011
Last Update Date: 01/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6996 CHARLES TOWN RD
KEARNEYSVILLE WV
25430-2770
US

IV. Provider business mailing address

6996 CHARLES TOWN RD
KEARNEYSVILLE WV
25430-2770
US

V. Phone/Fax

Practice location:
  • Phone: 304-692-0299
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number0284
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: