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Individual

DR. RANDI L ERICKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY D LP

Contact information

Practice address
2910 ENLOE ST, HUDSON, WI 54016-8166
(715) 377-0000
(715) 377-0000
Mailing address
2910 ENLOE ST, HUDSON, WI 54016-8166
(715) 377-0000
(715) 377-0000

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2265057
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39147000
WI
Enumeration date
09/11/2006
Last updated
07/08/2007
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