Provider Demographics
NPI:1770889206
Name:CASSIDY, ERIN C (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:C
Last Name:CASSIDY
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 1:1670 SATIN LEAF CT
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-1252
Mailing Address - Country:US
Mailing Address - Phone:561-445-4545
Mailing Address - Fax:
Practice Address - Street 1:1670 SATIN LEAF CT
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-1252
Practice Address - Country:US
Practice Address - Phone:561-445-4545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-31
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 3330235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist