Individual
MRS. STEPHANIE ANN ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
663 E BROADWAY BLVD, JEFFERSON CITY, TN 37760-4906
(865) 606-0015
Mailing address
337 NANCY DR, JEFFERSON CITY, TN 37760-4623
(865) 867-4243
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
11975
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11975
MASSAGE LICENSE
TN
Enumeration date
01/11/2018
Last updated
04/25/2023
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