Provider Demographics
NPI:1235622606
Name:PHILLIPS, ERIN BROOKE (SLP)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:BROOKE
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 SCHOOLHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-2221
Mailing Address - Country:US
Mailing Address - Phone:516-729-9556
Mailing Address - Fax:631-423-7706
Practice Address - Street 1:175 WOLF HILL RD
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-1340
Practice Address - Country:US
Practice Address - Phone:631-423-7700
Practice Address - Fax:631-423-7706
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-11
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist