Individual
MRS. MARY WANDA ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.R., L
Contact information
Practice address
506 ROEDER CIR, 88TH RRC SURGEON'S OFFICE, FORT SNELLING, MN 55111-4017
(612) 713-3254
Mailing address
13788 CROCUS ST NW, ANDOVER, MN 55304-3729
(763) 755-5864
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
101266
MN
Other
Enumeration date
01/18/2007
Last updated
07/08/2007
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