Provider Demographics
NPI:1124509583
Name:O'REGAN, ERIN M (MS CCC SLP)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:M
Last Name:O'REGAN
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 OLD COLONY AVE APT 458
Mailing Address - Street 2:
Mailing Address - City:EAST TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02718-1135
Mailing Address - Country:US
Mailing Address - Phone:781-820-7061
Mailing Address - Fax:
Practice Address - Street 1:215 THATCHER ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02302-3949
Practice Address - Country:US
Practice Address - Phone:508-583-5834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA76394235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist