Provider Demographics
NPI:1962954214
Name:ERLBAUM, SHEILA JUDITH (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:JUDITH
Last Name:ERLBAUM
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W SCHOOL HOUSE LN
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-3404
Mailing Address - Country:US
Mailing Address - Phone:215-951-4742
Mailing Address - Fax:
Practice Address - Street 1:100 W SCHOOL HOUSE LN
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19144-3404
Practice Address - Country:US
Practice Address - Phone:215-951-4742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-02
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL000357L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist