Provider Demographics
NPI:1821166109
Name:MADDEN, ERIN MARIE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:MARIE
Last Name:MADDEN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:MARIE
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:17695 KELLEY RD
Mailing Address - Street 2:
Mailing Address - City:PECATONICA
Mailing Address - State:IL
Mailing Address - Zip Code:61063-9315
Mailing Address - Country:US
Mailing Address - Phone:810-772-9948
Mailing Address - Fax:
Practice Address - Street 1:17695 KELLEY RD
Practice Address - Street 2:
Practice Address - City:PECATONICA
Practice Address - State:IL
Practice Address - Zip Code:61063-9315
Practice Address - Country:US
Practice Address - Phone:810-772-9948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-02
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist