Provider Demographics
NPI:1083045728
Name:STOSICH, ERIN
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:STOSICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 N WEST AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-1314
Mailing Address - Country:US
Mailing Address - Phone:605-231-2490
Mailing Address - Fax:
Practice Address - Street 1:1973 MORNINGSIDE RD
Practice Address - Street 2:APT 217
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-8936
Practice Address - Country:US
Practice Address - Phone:402-750-6626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-05
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1663225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist