| NPI | 1508270158 |
|---|---|
| Former Name | HEIDI JO ERICKSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 4679) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NC 103064) |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2015-03-16 |