Provider Demographics
NPI:1659820884
Name:GUARDASCIONE, ERICA (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:GUARDASCIONE
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 1:50 HOOK MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:MONTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07045-9620
Mailing Address - Country:US
Mailing Address - Phone:973-978-3758
Mailing Address - Fax:
Practice Address - Street 1:300 MARKET ST
Practice Address - Street 2:
Practice Address - City:SADDLE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07663-5309
Practice Address - Country:US
Practice Address - Phone:201-368-6017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-29
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00611900235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist