Provider Demographics
NPI:1548749765
Name:IMBURGIA, ERIN
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:IMBURGIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 BECKETT STE 201
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-1372
Mailing Address - Country:US
Mailing Address - Phone:210-998-2330
Mailing Address - Fax:
Practice Address - Street 1:1003 BECKETT STE 201
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213-1372
Practice Address - Country:US
Practice Address - Phone:210-998-2330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist