Provider Demographics
NPI:1912496894
Name:TROJAN, ERIKA (RBT-16-20239)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:TROJAN
Suffix:
Gender:F
Credentials:RBT-16-20239
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 GRANDVIEW CT
Mailing Address - Street 2:
Mailing Address - City:ALGONQUIN
Mailing Address - State:IL
Mailing Address - Zip Code:60102-1990
Mailing Address - Country:US
Mailing Address - Phone:815-245-2977
Mailing Address - Fax:
Practice Address - Street 1:201 GRANDVIEW CT
Practice Address - Street 2:
Practice Address - City:ALGONQUIN
Practice Address - State:IL
Practice Address - Zip Code:60102-1990
Practice Address - Country:US
Practice Address - Phone:815-245-2977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-06
Last Update Date:2018-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL16-20239106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician