Provider Demographics
NPI:1598530412
Name:TOOKER, ERICA MARIE (MA, CCLS)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:MARIE
Last Name:TOOKER
Suffix:
Gender:F
Credentials:MA, CCLS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 N 11TH ST
Mailing Address - Street 2:
Mailing Address - City:GUNNISON
Mailing Address - State:CO
Mailing Address - Zip Code:81230-3317
Mailing Address - Country:US
Mailing Address - Phone:517-896-4768
Mailing Address - Fax:
Practice Address - Street 1:402 N 11TH ST
Practice Address - Street 2:
Practice Address - City:GUNNISON
Practice Address - State:CO
Practice Address - Zip Code:81230-3317
Practice Address - Country:US
Practice Address - Phone:517-896-4768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1123755174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist