Provider Demographics
NPI:1194755298
Name:BRACE, ERIKA HAYLEY
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:HAYLEY
Last Name:BRACE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:
Other - Last Name:KAHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:26 TREE TOP LANE
Mailing Address - Street 2:
Mailing Address - City:WEST HENRIETTA
Mailing Address - State:NY
Mailing Address - Zip Code:14586-9531
Mailing Address - Country:US
Mailing Address - Phone:585-727-2943
Mailing Address - Fax:
Practice Address - Street 1:26 TREE TOP LANE
Practice Address - Street 2:
Practice Address - City:WEST HENRIETTA
Practice Address - State:NY
Practice Address - Zip Code:14586-9531
Practice Address - Country:US
Practice Address - Phone:585-727-2943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010837235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist