Provider Demographics
NPI:1659061885
Name:LARSON, ERIKA ANN (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ERIKA
Middle Name:ANN
Last Name:LARSON
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 S 30TH ST
Mailing Address - Street 2:
Mailing Address - City:ESCANABA
Mailing Address - State:MI
Mailing Address - Zip Code:49829-1194
Mailing Address - Country:US
Mailing Address - Phone:906-399-7402
Mailing Address - Fax:
Practice Address - Street 1:2510 1ST AVE N
Practice Address - Street 2:SUITE 2
Practice Address - City:ESCANABA
Practice Address - State:MI
Practice Address - Zip Code:49829
Practice Address - Country:US
Practice Address - Phone:906-399-7402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101007737235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist