Individual
JEREMY ERICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MAMFTC
Contact information
Practice address
232 GOODMAN RD W STE 305, SOUTHAVEN, MS 38671-8004
(662) 856-9563
Mailing address
232 GOODMAN RD W STE 305, SOUTHAVEN, MS 38671-8004
(662) 856-9563
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2608
MS
101YP2500X
Professional Counselor
A1708258
AR
Other
Enumeration date
08/16/2018
Last updated
04/03/2024
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