Healthcare Provider Details

I. General information

NPI: 1982637229
Provider Name (Legal Business Name): ERIN HOLKER PHD, LP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 08/09/2022
Certification Date: 08/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 FULTON ST SE
MINNEAPOLIS MN
55455-4800
US

IV. Provider business mailing address

420 DELAWARE STREET SE, MMC 390
MINNEAPOLIS MN
55455
US

V. Phone/Fax

Practice location:
  • Phone: 612-624-1412
  • Fax: 612-624-4458
Mailing address:
  • Phone: 612-625-2661
  • Fax: 612-624-6686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberLP4336
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberLP 4336
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberLP 4336
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: