Provider Demographics
NPI:1962629659
Name:HENRY, ERIN GRAY (MS CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:GRAY
Last Name:HENRY
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 1:3919 BARNETT RD
Mailing Address - Street 2:#912
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76310-1725
Mailing Address - Country:US
Mailing Address - Phone:940-867-5841
Mailing Address - Fax:
Practice Address - Street 1:3919 BARNETT RD
Practice Address - Street 2:#912
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76310-1725
Practice Address - Country:US
Practice Address - Phone:940-867-5841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101403235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist