Provider Demographics
NPI:1457891400
Name:BRANSON, ERIN (MA CF SLP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:BRANSON
Suffix:
Gender:F
Credentials:MA CF SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 S 14TH ST
Mailing Address - Street 2:APT. 1
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-2015
Mailing Address - Country:US
Mailing Address - Phone:360-280-5890
Mailing Address - Fax:
Practice Address - Street 1:760 POLHEMUS RD
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-3938
Practice Address - Country:US
Practice Address - Phone:360-280-5890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-24
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist