Provider Demographics
NPI:1083217525
Name:LARSEN, ERIN M (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:M
Last Name:LARSEN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:M
Other - Last Name:WILCOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8506 E 61ST ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-1916
Mailing Address - Country:US
Mailing Address - Phone:918-357-4321
Mailing Address - Fax:
Practice Address - Street 1:8506 E 61ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-1916
Practice Address - Country:US
Practice Address - Phone:918-357-4321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist