Individual
MR. JERRY MARTIN ERICKSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
4702 W COMMERCIAL DR STE B3, NORTH LITTLE ROCK, AR 72116-7073
(501) 205-4570
Mailing address
29 ODOM RD, CONWAY, AR 72032-9031
(910) 286-2441
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A2009118
AR
Other
Enumeration date
02/04/2021
Last updated
02/04/2021
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