Provider Demographics
NPI:1114375144
Name:STEVENSON, ERIN (SLPA)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2112 SOUTHWIND CIR
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60194-4415
Mailing Address - Country:US
Mailing Address - Phone:708-415-6255
Mailing Address - Fax:
Practice Address - Street 1:2112 SOUTHWIND CIR
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60194-4415
Practice Address - Country:US
Practice Address - Phone:708-415-6255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-31
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2170002772355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant