Provider Demographics
NPI:1629755392
Name:BOMMERSBACH, ERINPATRICIA FLAHERTY (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ERINPATRICIA
Middle Name:FLAHERTY
Last Name:BOMMERSBACH
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:PATRICIA
Other - Last Name:FLAHERTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:2401 14TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:DEVILS LAKE
Mailing Address - State:ND
Mailing Address - Zip Code:58301-8632
Mailing Address - Country:US
Mailing Address - Phone:701-351-0988
Mailing Address - Fax:
Practice Address - Street 1:213 5TH ST NE
Practice Address - Street 2:
Practice Address - City:DEVILS LAKE
Practice Address - State:ND
Practice Address - Zip Code:58301-2425
Practice Address - Country:US
Practice Address - Phone:701-662-2216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist