Provider Demographics
NPI:1669148417
Name:GERMICK, ERIN RAE (MS, BCBA, LBA)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:RAE
Last Name:GERMICK
Suffix:
Gender:F
Credentials:MS, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5923 OLD SHAWNEE RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19963-3368
Mailing Address - Country:US
Mailing Address - Phone:302-245-1908
Mailing Address - Fax:
Practice Address - Street 1:4023 KENNETT PIKE # 988
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19807-2018
Practice Address - Country:US
Practice Address - Phone:484-577-9928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-20
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1-21-51001103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst