Provider Demographics
NPI:1669107579
Name:DECKER, ASPEN ERIK
Entity type:Individual
Prefix:
First Name:ASPEN
Middle Name:ERIK
Last Name:DECKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13507 N 145TH DR
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85379-6162
Mailing Address - Country:US
Mailing Address - Phone:202-681-1274
Mailing Address - Fax:
Practice Address - Street 1:13507 N 145TH DR
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85379-6162
Practice Address - Country:US
Practice Address - Phone:202-681-1274
Practice Address - Fax:202-335-6336
Is Sole Proprietor?:No
Enumeration Date:2022-07-24
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZNA405300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes405300000XOther Service ProvidersPrevention Professional