Individual
DR. CAROL JANE ERICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
620 W 19TH ST, STE 6, CHEYENNE, WY 82001-4307
(307) 637-5808
(307) 432-6775
Mailing address
620 W 19TH ST, STE 6, CHEYENNE, WY 82001-4307
(307) 637-5808
(307) 432-6775
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
303
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
310907
BC/BS
WY
Enumeration date
06/26/2007
Last updated
09/24/2007
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