Provider Demographics
NPI:1205616216
Name:BUTTON, ERIC MATTHEW
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:MATTHEW
Last Name:BUTTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 VERMONT AVE
Mailing Address - Street 2:
Mailing Address - City:HALETHORPE
Mailing Address - State:MD
Mailing Address - Zip Code:21227-3741
Mailing Address - Country:US
Mailing Address - Phone:443-716-5709
Mailing Address - Fax:
Practice Address - Street 1:21515 ZION RD
Practice Address - Street 2:
Practice Address - City:BROOKEVILLE
Practice Address - State:MD
Practice Address - Zip Code:20833-1009
Practice Address - Country:US
Practice Address - Phone:240-912-2220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-05
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02793L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist