Provider Demographics
NPI:1619620184
Name:HOLBY, ERIN NICOLE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:NICOLE
Last Name:HOLBY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:NICOLE
Other - Last Name:MULDOON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:WYOMING VALLEY CHILDREN'S ASSOCIATION
Mailing Address - Street 2:1133 WYOMING AVE
Mailing Address - City:FORTY FORT
Mailing Address - State:PA
Mailing Address - Zip Code:18704
Mailing Address - Country:US
Mailing Address - Phone:570-714-1246
Mailing Address - Fax:
Practice Address - Street 1:WYOMING VALLEY CHILDREN'S ASSOCIATION
Practice Address - Street 2:1133 WYOMING AVE
Practice Address - City:FORTY FORT
Practice Address - State:PA
Practice Address - Zip Code:18704
Practice Address - Country:US
Practice Address - Phone:570-714-1246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-03
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL015727235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist