Provider Demographics
NPI:1033492681
Name:STANNARD, ERIKA LEA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ERIKA
Middle Name:LEA
Last Name:STANNARD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:LEA
Other - Last Name:STANNARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:950 E BOGARD RD STE 233
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-7185
Mailing Address - Country:US
Mailing Address - Phone:907-357-4543
Mailing Address - Fax:907-357-4533
Practice Address - Street 1:950 E BOGARD RD STE 233
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7185
Practice Address - Country:US
Practice Address - Phone:907-357-4543
Practice Address - Fax:907-357-4533
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK100245103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist