| NPI | 1679963193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN RAYMOND ERICKSON Owner 814-466-2133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PS007918L) |
| Enumeration Date | 2015-02-04 |
| Last Update Date | 2015-02-05 |