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General NPI Number Information
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NPI Number | 1790504587
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Entity Type | Individual
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Provider Name | ERICKA DAWN MATTHEWS
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Gender | Female
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Dates
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Enumeration Date | 10/08/2024
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 1460 S PROVIDENCE CENTER DR STE 2
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City | CEDAR CITY
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State | UT
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Zip | 84720-1981
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Country | US
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Telephone | 435-586-4479
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Fax |
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Provider Business Mailing Address
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Address Line | 3777 N 170 E
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City | ENOCH
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State | UT
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Zip | 84721-7318
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Country | US
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Telephone | 435-590-4208
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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