Provider Demographics
NPI:1235760711
Name:BROXTON, ERIKA LYNN
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:LYNN
Last Name:BROXTON
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 1:4241 W HAWTHORNE TRACE RD APT 103
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-1033
Mailing Address - Country:US
Mailing Address - Phone:262-573-9322
Mailing Address - Fax:
Practice Address - Street 1:3026 W CONCORDIA AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-3853
Practice Address - Country:US
Practice Address - Phone:414-253-7494
Practice Address - Fax:414-296-0273
Is Sole Proprietor?:No
Enumeration Date:2020-02-03
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI132309-121OtherSOCIAL WORK LICENSE