Individual
BROOKE MICHELE ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
118 PALM AVE, MODESTO, CA 95350-5420
(209) 764-0124
Mailing address
118 PALM AVE, MODESTO, CA 95350-5420
(209) 764-0124
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
13487659-3502
UT
104100000X
Social Worker
ASW115113
CA
Other
Enumeration date
09/11/2023
Last updated
09/11/2023
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