| NPI | 1487059853 |
|---|---|
| Former Name | STACEY ERICKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MN 9408) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CO SLP.0001918) |
| Enumeration Date | 2014-10-28 |
| Last Update Date | 2023-01-04 |