Individual
MATTHEW P ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1683 S HIGHWAY 89 # 91, LOGAN, UT 84321-6212
(435) 755-8400
Mailing address
PO BOX 3662, LOGAN, UT 84323-3662
(435) 755-8400
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
321034-3501
UT
Other
Enumeration date
09/09/2019
Last updated
09/09/2019
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