Provider Demographics
NPI:1801594320
Name:ERICKSON, ALEXIS MALEEA
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:MALEEA
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1938 ENNIS JOSLIN RD UNIT 3701
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78412-4397
Mailing Address - Country:US
Mailing Address - Phone:515-490-8590
Mailing Address - Fax:
Practice Address - Street 1:1938 ENNIS JOSLIN RD UNIT 3701
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78412-4397
Practice Address - Country:US
Practice Address - Phone:515-490-8590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician