Provider Demographics
NPI:1053025502
Name:YEASIN, ERIN NICOLE (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:NICOLE
Last Name:YEASIN
Suffix:
Gender:
Credentials:CCC-SLP
Other - Prefix:MS
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:HEALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:3477 RIDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:CO
Mailing Address - Zip Code:80534-4128
Mailing Address - Country:US
Mailing Address - Phone:307-315-4779
Mailing Address - Fax:
Practice Address - Street 1:3477 RIDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:CO
Practice Address - Zip Code:80534-4128
Practice Address - Country:US
Practice Address - Phone:307-315-4779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-10
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSLP.0005211235Z00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist