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General NPI Number Information
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NPI Number | 1801665765
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Entity Type | Individual
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Provider Name | ANTONIA ERAZO MSW, LCSWA
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Gender | Female
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Dates
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Enumeration Date | 12/20/2023
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Last Update Date | 12/20/2023
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Provider Practice Location Address
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Address Line | 1146 NC HIGHWAY 86 N
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City | YANCEYVILLE
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State | NC
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Zip | 27379-8646
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Country | US
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Telephone | 336-694-1175
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Fax |
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Provider Business Mailing Address
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Address Line | 3211 PLEASANT GARDEN RD APT 1D
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City | GREENSBORO
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State | NC
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Zip | 27406-4666
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Country | US
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Telephone | 336-908-6559
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | P0109337
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License Number State | NC
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