Provider Demographics
NPI:1639749161
Name:ERICKSON, ARYN ELIZABETH (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ARYN
Middle Name:ELIZABETH
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 N ROADRUNNER PKWY APT 305
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-9052
Mailing Address - Country:US
Mailing Address - Phone:715-308-0864
Mailing Address - Fax:
Practice Address - Street 1:301 N ROADRUNNER PKWY APT 305
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-9052
Practice Address - Country:US
Practice Address - Phone:715-308-0864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1001344145235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist