Doctor Name: | MS. DONNA M ERICKSON |
NPI Number: | 1366635872 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 43 Oliver St Wading River, NY - 117921037 |
Business Phone Number: | 6317909796 |
Business Fax Number: | |
Mailing Address: | 43 Oliver St, WADING RIVER |
State: | NY |
Postal Code: | 117921037 |
Phone Number: | 6317909796 |
Fax Number: | |
NPI Enumeration Date: | 08/20/2007 |
NPI Last Update Date: | 08/20/2007 |
Replacement NPI: | 0 |
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NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TM1800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Mental Retardation & Developmental Disabilities |
Taxonomy Definition: |