Provider Demographics
NPI:1811977622
Name:STAATS, ERYN LYNNE (AUD)
Entity type:Individual
Prefix:MRS
First Name:ERYN
Middle Name:LYNNE
Last Name:STAATS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 COLEMANS XING STE 200
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-7080
Mailing Address - Country:US
Mailing Address - Phone:937-578-4300
Mailing Address - Fax:937-578-4301
Practice Address - Street 1:140 COLEMANS XING STE 200
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-7080
Practice Address - Country:US
Practice Address - Phone:937-578-4300
Practice Address - Fax:937-578-4301
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA01488231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0094740Medicaid
OHST4103882Medicare PIN