Provider Demographics
NPI:1952434623
Name:ERHARDT, MARCIA A (LLP)
Entity Type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:A
Last Name:ERHARDT
Suffix:
Gender:F
Credentials:LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2633 S LAPEER RD
Mailing Address - Street 2:
Mailing Address - City:ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48360-2810
Mailing Address - Country:US
Mailing Address - Phone:248-393-5555
Mailing Address - Fax:248-393-1791
Practice Address - Street 1:2633 S LAPEER RD
Practice Address - Street 2:
Practice Address - City:ORION
Practice Address - State:MI
Practice Address - Zip Code:48360-2810
Practice Address - Country:US
Practice Address - Phone:248-393-5555
Practice Address - Fax:248-393-1791
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301007202103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical