Provider Demographics
NPI:1932482288
Name:SOUTH, ERIN CATHLEEN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:CATHLEEN
Last Name:SOUTH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 S ALMA SCHOOL RD
Mailing Address - Street 2:UNITE A216
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-3064
Mailing Address - Country:US
Mailing Address - Phone:480-420-6686
Mailing Address - Fax:
Practice Address - Street 1:1930 S ALMA SCHOOL RD
Practice Address - Street 2:UNIT A216
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-3064
Practice Address - Country:US
Practice Address - Phone:480-420-6686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4216103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist