Provider Demographics
NPI:1205143211
Name:HOVER, ERIKA MAE (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ERIKA
Middle Name:MAE
Last Name:HOVER
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 1:2399 BROOKVIEW RD
Mailing Address - Street 2:
Mailing Address - City:CASTLETON
Mailing Address - State:NY
Mailing Address - Zip Code:12033-9712
Mailing Address - Country:US
Mailing Address - Phone:518-428-5953
Mailing Address - Fax:
Practice Address - Street 1:210 BALLSTON AVE
Practice Address - Street 2:BALLSTON SPA CSD
Practice Address - City:BALLSTON SPA
Practice Address - State:NY
Practice Address - Zip Code:12020-3606
Practice Address - Country:US
Practice Address - Phone:518-884-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016066235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist