Provider Demographics
NPI:1750447652
Name:MCELWAIN, ERIN (SLP0)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:MCELWAIN
Suffix:
Gender:F
Credentials:SLP0
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6840 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-5306
Mailing Address - Country:US
Mailing Address - Phone:928-853-4226
Mailing Address - Fax:
Practice Address - Street 1:930 W SOUTHERN AVE
Practice Address - Street 2:STE #10
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-4938
Practice Address - Country:US
Practice Address - Phone:480-835-0857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP4359235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ989395Medicaid