Provider Demographics
NPI:1518757574
Name:CORREA, ERICA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:CORREA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 CHERIMOYA ST
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34981-5308
Mailing Address - Country:US
Mailing Address - Phone:954-478-2135
Mailing Address - Fax:954-478-2135
Practice Address - Street 1:470 CHERIMOYA ST
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34981-5308
Practice Address - Country:US
Practice Address - Phone:954-478-2135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA22529235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist