Provider Demographics
NPI:1427352442
Name:DEVAULT, ERIN A (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:A
Last Name:DEVAULT
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MISS
Other - First Name:ERIN
Other - Middle Name:A
Other - Last Name:CANADAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:1200 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-2442
Mailing Address - Country:US
Mailing Address - Phone:215-483-2461
Mailing Address - Fax:215-483-4597
Practice Address - Street 1:1200 RIVER RD
Practice Address - Street 2:
Practice Address - City:CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428-2442
Practice Address - Country:US
Practice Address - Phone:215-483-2461
Practice Address - Fax:215-483-4597
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-05
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL010234235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist