Provider Demographics
NPI:1396587721
Name:MILKS, ERIN MIRANDA (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:MIRANDA
Last Name:MILKS
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:MIRANDA
Other - Last Name:VERDUZCO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:265 W BULLARD AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-1755
Mailing Address - Country:US
Mailing Address - Phone:559-205-0930
Mailing Address - Fax:
Practice Address - Street 1:265 W BULLARD AVE STE 102
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-1755
Practice Address - Country:US
Practice Address - Phone:559-205-0930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist