Provider Demographics
NPI:1316293434
Name:DICKENS, ERIN COBBLER (AUD)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:COBBLER
Last Name:DICKENS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 LAKE BOONE TRL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-7528
Mailing Address - Country:US
Mailing Address - Phone:919-787-1374
Mailing Address - Fax:919-571-8135
Practice Address - Street 1:4600 LAKE BOONE TRL
Practice Address - Street 2:SUITE 100
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-7528
Practice Address - Country:US
Practice Address - Phone:919-787-1374
Practice Address - Fax:919-571-8135
Is Sole Proprietor?:No
Enumeration Date:2012-07-26
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10041237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter