Provider Demographics
NPI:1376097899
Name:ERIN HARTY SPEECH-LANGUAGE PATHOLOGY, PC
Entity Type:Organization
Organization Name:ERIN HARTY SPEECH-LANGUAGE PATHOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-676-8900
Mailing Address - Street 1:28936 OLD TOWN FRONT ST
Mailing Address - Street 2:STE 104
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-2804
Mailing Address - Country:US
Mailing Address - Phone:951-676-8900
Mailing Address - Fax:951-234-0144
Practice Address - Street 1:28936 OLD TOWN FRONT ST
Practice Address - Street 2:STE 104
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-2804
Practice Address - Country:US
Practice Address - Phone:951-676-8900
Practice Address - Fax:951-234-0144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-12
Last Update Date:2016-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20174235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty