Provider Demographics
NPI:1689118960
Name:ERIN RICHARDSON, LLC
Entity Type:Organization
Organization Name:ERIN RICHARDSON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLP/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:YOUNG
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:502-370-6703
Mailing Address - Street 1:13311 TUCKER LAKE DRIVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-4581
Mailing Address - Country:US
Mailing Address - Phone:502-370-6703
Mailing Address - Fax:502-688-6659
Practice Address - Street 1:13311 TUCKER LAKE DRIVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-4581
Practice Address - Country:US
Practice Address - Phone:502-370-6703
Practice Address - Fax:502-688-6659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-06
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY138650235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty