Provider Demographics
NPI:1679705321
Name:HERLIHY, ERIN MARIE (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:MARIE
Last Name:HERLIHY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:MARIE
Other - Last Name:MCLOUGHLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:310 CONCORD AVE
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-2917
Mailing Address - Country:US
Mailing Address - Phone:516-357-3684
Mailing Address - Fax:
Practice Address - Street 1:310 CONCORD AVE
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-2917
Practice Address - Country:US
Practice Address - Phone:516-357-3684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-13
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008761-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist