Individual
MRS. SHANNON RAE ERICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED., CCC-SLP
Contact information
Practice address
3230 JUNCTION ST, DURANGO, CO 81301-4141
(970) 335-8115
Mailing address
3230 JUNCTION ST, DURANGO, CO 81301-4141
(970) 335-8115
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
0001761
CO
235Z00000X
Speech-Language Pathologist
113334
TX
235Z00000X
Speech-Language Pathologist
Primary
4412
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142860721
—
AR
01
—
5U956
BLUE CROSS
AR
Enumeration date
04/17/2006
Last updated
08/04/2025
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