Individual
DIANA JEAN ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3610 S 1000 W, SALT LAKE CITY, UT 84119-7829
(801) 288-8400
Mailing address
PO BOX 13741, OGDEN, UT 84412-3741
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
5371893-3102
UT
Other
Enumeration date
01/26/2006
Last updated
03/19/2008
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