Provider Demographics
NPI:1194486159
Name:ECKMAN, ERIKA CHELSEA (CCC-SLP)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:CHELSEA
Last Name:ECKMAN
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 1:3 BUTLER ST
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER CENTER
Mailing Address - State:MA
Mailing Address - Zip Code:02124-5713
Mailing Address - Country:US
Mailing Address - Phone:607-742-9901
Mailing Address - Fax:
Practice Address - Street 1:19 CROSBY DR
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01730-1401
Practice Address - Country:US
Practice Address - Phone:781-245-4446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-03
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA78221235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist