Provider Demographics
NPI:1215596812
Name:BAUER, ERIN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:
Last Name:BAUER
Suffix:
Gender:F
Credentials:MS, 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:PO BOX 850
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MT
Mailing Address - Zip Code:59870-0850
Mailing Address - Country:US
Mailing Address - Phone:406-370-0696
Mailing Address - Fax:
Practice Address - Street 1:974 SHEPHERD LN
Practice Address - Street 2:
Practice Address - City:STEVENSVILLE
Practice Address - State:MT
Practice Address - Zip Code:59870-6712
Practice Address - Country:US
Practice Address - Phone:406-370-0696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-07
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTSLP-ST-LIC-3198235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist