Provider Demographics
NPI:1053049429
Name:MANN, ERIN ELIZABETH (CCC-SLP)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:ELIZABETH
Last Name:MANN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:ELIZABETH
Other - Last Name:HOLZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:6732 WISE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63139-3728
Mailing Address - Country:US
Mailing Address - Phone:847-708-4844
Mailing Address - Fax:
Practice Address - Street 1:12110 CLAYTON RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2516
Practice Address - Country:US
Practice Address - Phone:314-989-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-12
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016020616235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist