Provider Demographics
NPI:1548743149
Name:HENRIQUEZ, ERIKA M
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:M
Last Name:HENRIQUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:MELISSA
Other - Last Name:GODINEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1832 PALO ALTO DR
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-6844
Mailing Address - Country:US
Mailing Address - Phone:214-534-7987
Mailing Address - Fax:
Practice Address - Street 1:1832 PALO ALTO DR
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-6844
Practice Address - Country:US
Practice Address - Phone:214-534-7987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX391472355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant