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NPI Code Detail

MEDICARE: ERICKA RALPH

MEDICARE: ERICKA RALPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2101YP2500XProfessional Counselor3687TN

General Provider Information

NPI Number : 1609224534
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICKA RALPH
Provider Business Mailing Address
First Line : 301 S PERIMETER PARK DR
Second Line :
City : NASHVILLE
State : TN
Zip : 37211-4143
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1635 CHESTNUT ST
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37408-1024
Country : US
Telephone Number : 864-525-0391
Fax Number : 865-525-0393
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2016
Last Update Date : 10/21/2016

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