Provider Demographics
NPI:1538765771
Name:CARACHILO, ERIKA (MA, CCC-SLP, CLT)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:CARACHILO
Suffix:
Gender:F
Credentials:MA, CCC-SLP, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 LINDLEY RD
Mailing Address - Street 2:
Mailing Address - City:GLENSIDE
Mailing Address - State:PA
Mailing Address - Zip Code:19038-2045
Mailing Address - Country:US
Mailing Address - Phone:215-828-1390
Mailing Address - Fax:215-537-7872
Practice Address - Street 1:1331 E WYOMING AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19124-3808
Practice Address - Country:US
Practice Address - Phone:215-537-7659
Practice Address - Fax:215-537-7872
Is Sole Proprietor?:No
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL004648L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist