Provider Demographics
NPI:1578945200
Name:CONLAN, ERIN E (MS ED, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:E
Last Name:CONLAN
Suffix:
Gender:F
Credentials:MS ED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 SPRUCE CT
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-2015
Mailing Address - Country:US
Mailing Address - Phone:603-433-4192
Mailing Address - Fax:
Practice Address - Street 1:2064 WOODBURY AVE
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:NH
Practice Address - Zip Code:03801-7801
Practice Address - Country:US
Practice Address - Phone:603-433-4192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-18
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1-08-4192103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst