Provider Demographics
NPI:1508698507
Name:JUDSON, ERIN (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:JUDSON
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:KROLL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:13943 RECUERDO DR
Mailing Address - Street 2:
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-3128
Mailing Address - Country:US
Mailing Address - Phone:619-957-2800
Mailing Address - Fax:
Practice Address - Street 1:13943 RECUERDO DR
Practice Address - Street 2:
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-3128
Practice Address - Country:US
Practice Address - Phone:619-957-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-17
Last Update Date:2024-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP12638235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist