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General NPI Number Information
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NPI Number | 1720679665
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Entity Type | Individual
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Provider Name | ERIN BEAUDRY
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Gender | Female
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Dates
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Enumeration Date | 02/02/2021
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 3300 VAN BUREN ST STE A6
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City | HUDSONVILLE
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State | MI
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Zip | 49426-1132
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Country | US
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Telephone | 616-229-0525
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Fax |
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Provider Business Mailing Address
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Address Line | 221 KATHRYN LN
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City | NORTH AURORA
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State | IL
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Zip | 60542-1750
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Country | US
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Telephone | 630-253-8458
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 146.015396
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 7101007844
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License Number State | MI
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