Provider Demographics
NPI:1093099061
Name:DOERING, ERICA Y
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:Y
Last Name:DOERING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 N WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72601-3518
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:870-208-8139
Practice Address - Street 1:521 N WILLOW ST
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601-3518
Practice Address - Country:US
Practice Address - Phone:417-827-0712
Practice Address - Fax:870-429-1012
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-07
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3965235Z00000X
2355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant