Provider Demographics
NPI:1437896842
Name:ERICKSON, SARA KRISTIN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:KRISTIN
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3908 BRUSHY RIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-8348
Mailing Address - Country:US
Mailing Address - Phone:678-576-6753
Mailing Address - Fax:
Practice Address - Street 1:1475 HOLCOMB BRIDGE RD STE 113
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-2126
Practice Address - Country:US
Practice Address - Phone:678-591-3542
Practice Address - Fax:770-234-6837
Is Sole Proprietor?:No
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist