Provider Demographics
NPI:1659505758
Name:BOEN, ERIN ELIZABETH (MA)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:ELIZABETH
Last Name:BOEN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:CASSIDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:1552 MALL DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-3110
Mailing Address - Country:US
Mailing Address - Phone:319-351-5437
Mailing Address - Fax:319-351-5432
Practice Address - Street 1:1552 MALL DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-3110
Practice Address - Country:US
Practice Address - Phone:319-351-5437
Practice Address - Fax:319-351-5432
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-05
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist