Provider Demographics
NPI:1891415725
Name:LIPMAN, ERICKA AMY (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ERICKA
Middle Name:AMY
Last Name:LIPMAN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:ERICKA
Other - Middle Name:AMY
Other - Last Name:HOOTNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:3165 KASSAB LN
Mailing Address - Street 2:
Mailing Address - City:COMMERCE TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48382-4613
Mailing Address - Country:US
Mailing Address - Phone:248-390-2475
Mailing Address - Fax:
Practice Address - Street 1:2045 E WEST MAPLE RD
Practice Address - Street 2:
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48390-3801
Practice Address - Country:US
Practice Address - Phone:248-926-0909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101006070235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist