Provider Demographics
NPI:1518298645
Name:FRISONE, ERIN M (MA ,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:M
Last Name:FRISONE
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 1:105 MECHANIC ST
Mailing Address - Street 2:WINDWARD GARDENS
Mailing Address - City:CAMDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04843-1811
Mailing Address - Country:US
Mailing Address - Phone:207-236-2573
Mailing Address - Fax:
Practice Address - Street 1:105 MECHANIC ST
Practice Address - Street 2:WINDWARD GARDENS
Practice Address - City:CAMDEN
Practice Address - State:ME
Practice Address - Zip Code:04843-1811
Practice Address - Country:US
Practice Address - Phone:207-236-2573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-29
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP1329235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist