Provider Demographics
NPI:1184396483
Name:GAYTAN, ERIKA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:GAYTAN
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 1:3982 LONNA CT
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-5822
Mailing Address - Country:US
Mailing Address - Phone:832-792-9862
Mailing Address - Fax:
Practice Address - Street 1:3982 LONNA CT
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-5822
Practice Address - Country:US
Practice Address - Phone:832-792-9862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.14371235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist