Provider Demographics
NPI:1366682395
Name:MANKOFF, ERICA JAYE (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:JAYE
Last Name:MANKOFF
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 1:431 E CENTRAL BLVD APT 301
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-1901
Mailing Address - Country:US
Mailing Address - Phone:407-256-4035
Mailing Address - Fax:
Practice Address - Street 1:431 E CENTRAL BLVD APT 301
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-1901
Practice Address - Country:US
Practice Address - Phone:407-256-4035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ4541235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist