Provider Demographics
NPI:1578603114
Name:CAMPBELL, ERIN ALICIA (MA, CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:ERIN
Middle Name:ALICIA
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MA, CCC-SLP
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Other - First Name:
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Mailing Address - Street 1:395 BRITTANY FARMS RD
Mailing Address - Street 2:APARTMENT 333
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06053-1100
Mailing Address - Country:US
Mailing Address - Phone:860-229-9691
Mailing Address - Fax:
Practice Address - Street 1:91 NORTHWEST DR
Practice Address - Street 2:NORTHWEST VILLAGE SCHOOL
Practice Address - City:PLAINVILLE
Practice Address - State:CT
Practice Address - Zip Code:06062-1534
Practice Address - Country:US
Practice Address - Phone:860-793-3500
Practice Address - Fax:860-793-3521
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT003701235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist