Provider Demographics
NPI:1033835947
Name:STORMONT, ERIKA MARIE (MS)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:MARIE
Last Name:STORMONT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:MARIE
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1709 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-6502
Mailing Address - Country:US
Mailing Address - Phone:918-251-2626
Mailing Address - Fax:
Practice Address - Street 1:1709 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-6502
Practice Address - Country:US
Practice Address - Phone:918-251-2626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKCF408235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist