Doctor Name: | TONJA ERICKSON |
NPI Number: | 1003128331 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.C.P.C |
License Number: | 1499 |
Business Practice Address: | 109 N 4th St Hamilton, MT - 598402401 |
Business Phone Number: | 4063695268 |
Business Fax Number: | |
Mailing Address: | Po Box 692, CORVALLIS |
State: | MT |
Postal Code: | 598280692 |
Phone Number: | 4063695268 |
Fax Number: | |
NPI Enumeration Date: | 07/01/2010 |
NPI Last Update Date: | 07/01/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 1499 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |