MARK ERIC ERICSON

PHOENIX, AZ
NPI1609817386
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: MO  2002020181)
Enumeration Date2006-06-10
Last Update Date2007-07-08
Business Address
Mr. MARK ERIC ERICSON LCSW
650 E INDIAN SCHOOL RD MHICM
PHOENIX, AZ 85012-1839
Phone number: 602-277-5551
Mailing Address
Mr. MARK ERIC ERICSON LCSW
650 E INDIAN SCHOOL RD MHICM
PHOENIX, AZ 85012-1839
Phone number: 602-277-5551