Provider Demographics
NPI:1316012685
Name:DERR, ERIN COYNE (SLP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:COYNE
Last Name:DERR
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 1:2910 CRYSTAL FALLS DR
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77345-1303
Mailing Address - Country:US
Mailing Address - Phone:832-233-3385
Mailing Address - Fax:
Practice Address - Street 1:2755 CHESTNUT RIDGE DR
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-2497
Practice Address - Country:US
Practice Address - Phone:281-441-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24654235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist