Basic Information
Provider Information
NPI: 1255495578
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BROWN
FirstName: ERIN
MiddleName: GALLAGHER
NamePrefix: DR.
NameSuffix:  
Credential: AUD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 18507 TURTLE DR
Address2:  
City: LUTZ
State: FL
PostalCode: 335484461
CountryCode: US
TelephoneNumber: 8139499100
FaxNumber:  
Practice Location
Address1: 4443 ROWAN ROAD
Address2:  
City: NEW PORT RICHEY
State: FL
PostalCode: 34653
CountryCode: US
TelephoneNumber: 7278345425
FaxNumber: 7278345421
Other Information
ProviderEnumerationDate: 12/21/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
231H00000XAY793FLY Speech, Language and Hearing Service ProvidersAudiologist 

No ID Information.


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