Provider Demographics
NPI:1487795191
Name:FLANIGAN, ERIKA KRISTIN (MS, CCC/SLP)
Entity type:Individual
Prefix:MS
First Name:ERIKA
Middle Name:KRISTIN
Last Name:FLANIGAN
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 SW 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33060-9010
Mailing Address - Country:US
Mailing Address - Phone:954-895-5623
Mailing Address - Fax:954-943-7092
Practice Address - Street 1:1620 SW 5TH AVE
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33060-9010
Practice Address - Country:US
Practice Address - Phone:954-895-5623
Practice Address - Fax:954-943-7092
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA6673235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001074200Medicaid
FL887366600Medicaid