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General NPI Number Information
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NPI Number | 1891474458
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Entity Type | Organization
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Legal Business Name | ERIKA LARSON SPEECH THERAPY
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Dates
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Enumeration Date | 07/12/2023
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Last Update Date | 06/17/2024
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Provider Practice Location Address
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Address Line | 2510 1ST AVE N STOP 2
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City | ESCANABA
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State | MI
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Zip | 49829-1385
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Country | US
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Telephone | 906-399-7402
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Fax | 833-895-1411
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Provider Business Mailing Address
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Address Line | 909 S 30TH ST
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City | ESCANABA
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State | MI
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Zip | 49829-1194
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Country | US
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Telephone | 906-399-7402
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Fax |
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | MRS. ERIKA ANN LARSON
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Credential | MS CCC-SLLP
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Telephone | 906-399-7402
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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 |
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License Number State |
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