Provider Demographics
NPI:1780081885
Name:MUSKOPF, ERICA (MA,CCC/SLP)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:MUSKOPF
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 1:4631 HICKORY WOODS LN
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-4517
Mailing Address - Country:US
Mailing Address - Phone:513-398-3741
Mailing Address - Fax:513-398-2169
Practice Address - Street 1:211 N EAST ST
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-1760
Practice Address - Country:US
Practice Address - Phone:513-398-0474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-04
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH6257235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist