Individual
DEREK JOHN ERICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
3720 23RD AVE S, MINNEAPOLIS, MN 55407-3010
(612) 272-6978
Mailing address
305 9TH ST, WINDOM, MN 56101-1658
(507) 832-8033
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
305050
MN
Other
Enumeration date
12/09/2018
Last updated
06/06/2024
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