Provider Demographics
NPI:1427831676
Name:HANSEN, ERICA (SLP-CF)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:HANSEN
Suffix:
Gender:F
Credentials:SLP-CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 S RECKER RD APT 306
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-7173
Mailing Address - Country:US
Mailing Address - Phone:916-622-0903
Mailing Address - Fax:
Practice Address - Street 1:3900 S MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85212-7005
Practice Address - Country:US
Practice Address - Phone:480-497-4032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist