Provider Demographics
NPI:1548453970
Name:MUNDAY, ERIN RENEE (SLP)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:RENEE
Last Name:MUNDAY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 CHURCHILL CT
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47905-7840
Mailing Address - Country:US
Mailing Address - Phone:317-439-9585
Mailing Address - Fax:
Practice Address - Street 1:34 CHURCHILL CT
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-7840
Practice Address - Country:US
Practice Address - Phone:317-439-9585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22004530A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist