Individual
JACEY ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1062 E LANCASTER AVE STE 15, BRYN MAWR, PA 19010-1552
(610) 304-4038
Mailing address
1062 E LANCASTER AVE STE 15, BRYN MAWR, PA 19010-1552
(610) 304-4038
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/05/2019
Last updated
08/05/2019
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