Provider Demographics
NPI:1528559200
Name:LIVINGSTON, ERIN MARIA (CF-SLP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:MARIA
Last Name:LIVINGSTON
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12427 FREMONT DR
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-6996
Mailing Address - Country:US
Mailing Address - Phone:804-475-9322
Mailing Address - Fax:
Practice Address - Street 1:3600 SAUNDERS AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-4328
Practice Address - Country:US
Practice Address - Phone:804-358-1874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2204000037235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty