Provider Demographics
NPI:1205957008
Name:WALSH, ERIN H (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:H
Last Name:WALSH
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 1:208 ONTARIO ST
Mailing Address - Street 2:
Mailing Address - City:PECKVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18452-1429
Mailing Address - Country:US
Mailing Address - Phone:570-489-8820
Mailing Address - Fax:
Practice Address - Street 1:2300 ADAMS AVE
Practice Address - Street 2:MCGOWAN CENTER
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18509-1514
Practice Address - Country:US
Practice Address - Phone:570-348-6299
Practice Address - Fax:570-961-4708
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL007377235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist