Provider Demographics
NPI:1992914170
Name:DENSMORE, ERIN DAWN (MA,CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:ERIN
Middle Name:DAWN
Last Name:DENSMORE
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 1:6091 MEDFORD DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-2456
Mailing Address - Country:US
Mailing Address - Phone:714-717-4658
Mailing Address - Fax:
Practice Address - Street 1:12060 VALLEY VIEW ST.
Practice Address - Street 2:SUITE 137
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92845
Practice Address - Country:US
Practice Address - Phone:714-901-1518
Practice Address - Fax:714-901-1359
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP15171235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist