Individual
ERICA JANE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2237 E RIDGEVIEW DR, WASILLA, AK 99654-1525
(907) 202-0064
Mailing address
2237 E RIDGEVIEW DR, WASILLA, AK 99654-1525
(907) 202-0064
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-48775
AK
Other
Enumeration date
01/31/2018
Last updated
01/31/2018
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