Provider Demographics
NPI:1043762842
Name:BURNS, ERIN LOUISE (SLP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:LOUISE
Last Name:BURNS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12501 E 200 S
Mailing Address - Street 2:
Mailing Address - City:LOOGOOTEE
Mailing Address - State:IN
Mailing Address - Zip Code:47553-5364
Mailing Address - Country:US
Mailing Address - Phone:812-709-3286
Mailing Address - Fax:812-709-3287
Practice Address - Street 1:1 LOOGOOTEE PLAZA
Practice Address - Street 2:
Practice Address - City:LOOGOOTEE
Practice Address - State:IN
Practice Address - Zip Code:47553
Practice Address - Country:US
Practice Address - Phone:812-709-3286
Practice Address - Fax:812-709-3287
Is Sole Proprietor?:No
Enumeration Date:2016-10-27
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22005469A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist