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NPI Code Detail

MEDICARE: SEAN ERICKSON RBT

MEDICARE: SEAN ERICKSON RBT
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1780259069
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEAN ERICKSON RBT
Provider Business Mailing Address
First Line : 2550 N HOLLYWOOD WAY STE 102
Second Line :
City : BURBANK
State : CA
Zip : 91505-5031
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6704 CENTRAL BLVD
Second Line :
City : ZIONSVILLE
State : IN
Zip : 46077-7600
Country : US
Telephone Number : 317-769-4335
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2021
Last Update Date : 05/20/2021

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Directions to “ SEAN ERICKSON RBT” Practice Location

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