Provider Demographics
NPI:1427589324
Name:HEINERICHS, ERIN (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:HEINERICHS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3515 W. MORELAND ROAD
Mailing Address - Street 2:
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-0000
Mailing Address - Country:US
Mailing Address - Phone:215-659-5599
Mailing Address - Fax:
Practice Address - Street 1:3515 W. MORELAND ROAD
Practice Address - Street 2:
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-0000
Practice Address - Country:US
Practice Address - Phone:215-659-5599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-22
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL007204235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist