| Doctor Name: | MS. ERICA BEVILACQUA |
| NPI Number: | 1699108936 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 10394 |
| Business Practice Address: | 2316 Historic Cir Morrisville, NC - 275608154 |
| Business Phone Number: | 2026098867 |
| Business Fax Number: | |
| Mailing Address: | 19 W 21st St, Suite 701 NEW YORK |
| State: | NY |
| Postal Code: | 100106805 |
| Phone Number: | 6462308190 |
| Fax Number: | |
| NPI Enumeration Date: | 08/09/2013 |
| NPI Last Update Date: | 08/09/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 10394 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |