Provider Demographics
NPI:1659915916
Name:KOLLADA, ERIN V (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:V
Last Name:KOLLADA
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:V
Other - Last Name:MARKLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:9002 N MERIDIAN ST STE 222
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5350
Mailing Address - Country:US
Mailing Address - Phone:317-573-4370
Mailing Address - Fax:317-819-0044
Practice Address - Street 1:11725 N ILLINIOS ST STE 445
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3010
Practice Address - Country:US
Practice Address - Phone:317-844-7059
Practice Address - Fax:317-819-0044
Is Sole Proprietor?:No
Enumeration Date:2019-10-30
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22004913A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist