Doctor Name: | DONNA H ERICSSON |
NPI Number: | 1578750410 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MED LPC |
License Number: | 3399 |
Business Practice Address: | 708 E Main Suite B Ada, OK - 74821 |
Business Phone Number: | 5804366530 |
Business Fax Number: | 5809279958 |
Mailing Address: | 20981 Cr1560, ADA |
State: | OK |
Postal Code: | 74820 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 09/25/2007 |
NPI Last Update Date: | 09/25/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 3399 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |