Provider Demographics
NPI:1558370809
Name:WYRICK, ERIN (MA, LPC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:WYRICK
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10800 PEBBLECREEK CT
Mailing Address - Street 2:
Mailing Address - City:BENBROOK
Mailing Address - State:TX
Mailing Address - Zip Code:76126-4519
Mailing Address - Country:US
Mailing Address - Phone:806-341-8758
Mailing Address - Fax:
Practice Address - Street 1:10800 PEBBLECREEK CT
Practice Address - Street 2:
Practice Address - City:BENBROOK
Practice Address - State:TX
Practice Address - Zip Code:76126-4519
Practice Address - Country:US
Practice Address - Phone:806-341-8758
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20059101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional