Provider Demographics
NPI:1124804547
Name:GEYER, ERICA (CCC-SLP)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:GEYER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4043 N ASCOT PL
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-1850
Mailing Address - Country:US
Mailing Address - Phone:513-668-9011
Mailing Address - Fax:
Practice Address - Street 1:160 MILLER RD
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-1286
Practice Address - Country:US
Practice Address - Phone:513-934-5393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-01
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH14362788235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist