Provider Demographics
NPI:1659544575
Name:COX, ERIN A (M ED, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:A
Last Name:COX
Suffix:
Gender:F
Credentials:M ED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 OSPREY CIR
Mailing Address - Street 2:
Mailing Address - City:TIFTON
Mailing Address - State:GA
Mailing Address - Zip Code:31794-1673
Mailing Address - Country:US
Mailing Address - Phone:229-560-3648
Mailing Address - Fax:229-238-3940
Practice Address - Street 1:521 OSPREY CIR
Practice Address - Street 2:
Practice Address - City:TIFTON
Practice Address - State:GA
Practice Address - Zip Code:31794-1673
Practice Address - Country:US
Practice Address - Phone:229-560-3648
Practice Address - Fax:229-238-3940
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-11
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP006835235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA169416557BMedicaid