Provider Demographics
NPI:1013228634
Name:WILLIS, ERIN (MS)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:
Last Name:WILLIS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:HAYES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:100 WINTHROP ST
Mailing Address - Street 2:APT. 5E
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-6072
Mailing Address - Country:US
Mailing Address - Phone:302-242-1751
Mailing Address - Fax:
Practice Address - Street 1:48 W 74TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-2401
Practice Address - Country:US
Practice Address - Phone:212-721-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-29
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist