Provider Demographics
NPI:1508306911
Name:HERMAN, ERIN LEIGH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:LEIGH
Last Name:HERMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 PHOENIX CT
Mailing Address - Street 2:
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-7770
Mailing Address - Country:US
Mailing Address - Phone:732-778-0540
Mailing Address - Fax:
Practice Address - Street 1:1021 W COMMODORE BLVD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-5372
Practice Address - Country:US
Practice Address - Phone:732-778-0540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-03
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-15-19273103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst