Provider Demographics
NPI:1750806170
Name:MCBRIDE, ERIN (MA CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:ERIN
Middle Name:
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2715 S ALMA SCHOOL RD STE 3
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-4402
Mailing Address - Country:US
Mailing Address - Phone:480-415-9733
Mailing Address - Fax:
Practice Address - Street 1:2715 S ALMA SCHOOL RD STE 3
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-4402
Practice Address - Country:US
Practice Address - Phone:480-415-9733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-07
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTSLP10739235Z00000X
AZSLP10739235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist