Provider Demographics
NPI:1750522462
Name:TAYLOR, ERIN (AUD)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:THOMSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:100 GANNETT DR STE C
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-5900
Mailing Address - Country:US
Mailing Address - Phone:207-828-0361
Mailing Address - Fax:207-874-1483
Practice Address - Street 1:100 FODEN RD, WEST, STE 100
Practice Address - Street 2:WEST
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106
Practice Address - Country:US
Practice Address - Phone:207-347-2910
Practice Address - Fax:207-523-8591
Is Sole Proprietor?:No
Enumeration Date:2009-03-11
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAP3038231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist