Provider Demographics
NPI:1003297185
Name:VENZA, ERIN
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:VENZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12007 N LAMAR BLVD
Mailing Address - Street 2:APT #1114
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78753-1700
Mailing Address - Country:US
Mailing Address - Phone:214-587-1604
Mailing Address - Fax:
Practice Address - Street 1:12007 N LAMAR BLVD
Practice Address - Street 2:APT #1114
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78753-1700
Practice Address - Country:US
Practice Address - Phone:214-587-1604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-15
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109365235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist