Provider Demographics
NPI:1932518040
Name:ERICKSEN HEARING SERVICES, LLC
Entity Type:Organization
Organization Name:ERICKSEN HEARING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST & CHIEF MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:ERICKSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC
Authorized Official - Phone:507-279-0251
Mailing Address - Street 1:25147 COUNTY ROAD 17
Mailing Address - Street 2:
Mailing Address - City:WINONA
Mailing Address - State:MN
Mailing Address - Zip Code:55987-5497
Mailing Address - Country:US
Mailing Address - Phone:509-279-0251
Mailing Address - Fax:866-350-0374
Practice Address - Street 1:25147 COUNTY ROAD 17
Practice Address - Street 2:
Practice Address - City:WINONA
Practice Address - State:MN
Practice Address - Zip Code:55987-5497
Practice Address - Country:US
Practice Address - Phone:509-279-0251
Practice Address - Fax:866-350-0374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-04
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5013231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty