Healthcare Provider Details

I. General information

NPI: 1720362239
Provider Name (Legal Business Name): ERIN ESCHRICH M.S., TLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2011
Last Update Date: 10/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10532 N PORT WASHINGTON RD STE 1B
MEQUON WI
53092-5563
US

IV. Provider business mailing address

10532 N PORT WASHINGTON RD STE 1B
MEQUON WI
53092-5563
US

V. Phone/Fax

Practice location:
  • Phone: 262-242-3810
  • Fax: 262-242-3816
Mailing address:
  • Phone: 262-242-3810
  • Fax: 262-242-3816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1017-226
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: