Provider Demographics
NPI:1174846521
Name:PRYOR, ERIN NICOLE (MS/SLP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:NICOLE
Last Name:PRYOR
Suffix:
Gender:F
Credentials:MS/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:384 AQUAVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SHEPHERDSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40165-8810
Mailing Address - Country:US
Mailing Address - Phone:502-235-5907
Mailing Address - Fax:
Practice Address - Street 1:4604 LOWE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-1514
Practice Address - Country:US
Practice Address - Phone:502-451-1401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-11
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-09-026235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist