Provider Demographics
NPI:1407577505
Name:LAYLAND, ERICA
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:LAYLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:
Other - Last Name:GLIDEWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:917 CHEYENNE ST
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-2211
Mailing Address - Country:US
Mailing Address - Phone:318-840-4263
Mailing Address - Fax:
Practice Address - Street 1:1301 KIOWA ST
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-2280
Practice Address - Country:US
Practice Address - Phone:580-670-3117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-07
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
14358882235Z00000X
TX116390235Z00000X
OK5852235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist