Provider Demographics
NPI:1164025607
Name:HART, ERIN ALEECE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:ALEECE
Last Name:HART
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7625 E 87TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-4818
Mailing Address - Country:US
Mailing Address - Phone:918-357-8747
Mailing Address - Fax:
Practice Address - Street 1:7625 E 87TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-4818
Practice Address - Country:US
Practice Address - Phone:918-357-8747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3743235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist