Donna M Erickson

Individual provider Active NPI Intellectual & Developmental Disabilities Psychologist · Wading River, NY

NPI 1366635872 · NPPES record last updated Aug 20, 2007

Key facts

NPI
1366635872
Entity type
Individual (NPI type 1)
Primary specialty
Intellectual & Developmental Disabilities Psychologist 103TM1800X
Practice address
43 Oliver St
Wading River, NY 11792-1037
Phone
(631) 790-9796
NPI assigned
Aug 20, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual & Developmental Disabilities Psychologist 103TM1800X Yes

Addresses

Primary practice location

43 Oliver St
Wading River, NY 11792-1037

Mailing address

43 Oliver St
Wading River, NY 11792-1037
Phone (631) 790-9796

Other identifiers

IdentifierTypeStateIssuer
1942438OtherNYSTUDENTS WITH DISABILITIE

Other providers in Wading River, NY

All providers in Wading River, NY · Intellectual & Developmental Disabilities Psychologist in New York

Sources for this page

Verify at the official NPI Registry.