Provider Demographics
NPI:1023258837
Name:FALCONBURY, ERICA LEIGH (CCC-SLP)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:LEIGH
Last Name:FALCONBURY
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 1:1833 WARD DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-0558
Mailing Address - Country:US
Mailing Address - Phone:615-896-8046
Mailing Address - Fax:615-896-8981
Practice Address - Street 1:1833 WARD DR
Practice Address - Street 2:SUITE 103
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-0558
Practice Address - Country:US
Practice Address - Phone:615-896-8046
Practice Address - Fax:615-896-8981
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-06
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNSP0000003889235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist