Provider Demographics
NPI:1164569869
Name:TATUM, ERIKA (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:TATUM
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3345 BURNS RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4324
Mailing Address - Country:US
Mailing Address - Phone:561-691-4088
Mailing Address - Fax:561-691-1292
Practice Address - Street 1:3345 BURNS RD
Practice Address - Street 2:SUITE 301
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4324
Practice Address - Country:US
Practice Address - Phone:561-691-4088
Practice Address - Fax:561-691-1292
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA8848235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist