Provider Demographics
NPI:1922305531
Name:MESSINGER, ERIN M (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:M
Last Name:MESSINGER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17328 CASTILE RD
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33967-2560
Mailing Address - Country:US
Mailing Address - Phone:239-246-7696
Mailing Address - Fax:
Practice Address - Street 1:17328 CASTILE RD
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33967-2560
Practice Address - Country:US
Practice Address - Phone:239-246-7696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-16
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA9296235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist