Provider Demographics
NPI:1730489576
Name:RAY, ERIN MARIE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:MARIE
Last Name:RAY
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 1:4125 BRIARGATE PKWY
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-7804
Mailing Address - Country:US
Mailing Address - Phone:719-305-8000
Mailing Address - Fax:
Practice Address - Street 1:4125 BRIARGATE PKWY
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-7804
Practice Address - Country:US
Practice Address - Phone:719-305-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-27
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00642200235Z00000X
COSLP.0001747235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ41YS00642200OtherLICENSE