Provider Demographics
NPI:1629803135
Name:ERIKSEN, ERIN DAWN (MWSI)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:DAWN
Last Name:ERIKSEN
Suffix:
Gender:F
Credentials:MWSI
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:DAWN
Other - Last Name:ERIKSEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSWI
Mailing Address - Street 1:954 N 200 E
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84660-1247
Mailing Address - Country:US
Mailing Address - Phone:801-901-3330
Mailing Address - Fax:
Practice Address - Street 1:954 N 200 E
Practice Address - Street 2:
Practice Address - City:SPANISH FORK
Practice Address - State:UT
Practice Address - Zip Code:84660-1247
Practice Address - Country:US
Practice Address - Phone:801-901-3330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT874508105101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health