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Individual

BENJAMIN ERICKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
17505 N 79TH AVE STE 407, GLENDALE, AZ 85308-8732
(480) 498-7600
Mailing address
17505 N 79TH AVE STE 407, GLENDALE, AZ 85308-8732

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LAC-23649
AZ

Other

Enumeration date
08/04/2025
Last updated
08/04/2025
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