Organization
ERICKSON PSYCHOLOGICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN RAYMOND ERICKSON PHD (OWNER)
(814) 466-2133
Entity
Organization
Contact information
Practice address
315 S ALLEN ST, SUITE 421, STATE COLLEGE, PA 16801-4849
(814) 466-2133
Mailing address
315 S ALLEN ST, SUITE 421, STATE COLLEGE, PA 16801-4849
(814) 466-2133
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS007918L
PA
Other
Enumeration date
02/04/2015
Last updated
02/05/2015
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