Provider Demographics
NPI:1437904794
Name:ERWIN, ERIK DALE
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:DALE
Last Name:ERWIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 N 61ST ST
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-4358
Mailing Address - Country:US
Mailing Address - Phone:903-229-3730
Mailing Address - Fax:
Practice Address - Street 1:2220 BRYAN PL
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065-7126
Practice Address - Country:US
Practice Address - Phone:817-962-0409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-20
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor