Individual
JASON P ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCP
Contact information
Practice address
9333 E 21ST ST N, WICHITA, KS 67206-2927
(316) 634-4700
(316) 634-4770
Mailing address
PO BOX 467, NEWTON, KS 67114-0467
(316) 634-4700
(316) 634-4770
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
1149
KS
103TC0700X
Clinical Psychologist
Primary
1480
KS
Other
Enumeration date
01/22/2008
Last updated
06/11/2018
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