Individual
ERICA PATRICIA ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
69010 HIGHLAND DR #1, COTTONWOOD HEIGHTS, UT 84121, COTTONWOOD HEIGHTS, UT 84121-0000
(801) 935-4171
(000) 000-0000
Mailing address
1234 S 580 W, OREM, UT 84058-3321
(516) 301-8516
(000) 000-0000
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
NA
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000
NON MEDICAID IDENTIFIED
—
Enumeration date
11/13/2020
Last updated
11/13/2020
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