Provider Demographics
NPI:1497313944
Name:MORELLA, ERICA (MS CCC-SLP, TSSLD)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:
Last Name:MORELLA
Suffix:
Gender:F
Credentials:MS CCC-SLP, TSSLD
Other - Prefix:MS
Other - First Name:ERICA
Other - Middle Name:
Other - Last Name:HABER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP, TSSLD
Mailing Address - Street 1:146 PETER AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-4225
Mailing Address - Country:US
Mailing Address - Phone:347-668-1570
Mailing Address - Fax:
Practice Address - Street 1:300 RICHMOND TER
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-1512
Practice Address - Country:US
Practice Address - Phone:718-390-2190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-30
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029830235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist