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General NPI Number Information
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NPI Number | 1861228405
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Entity Type | Individual
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Provider Name | PAYTON ERDMANN
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Gender | Female
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Dates
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Enumeration Date | 09/10/2024
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Last Update Date | 09/10/2024
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Provider Practice Location Address
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Address Line | 1579 W RIVERSTONE DR STE 101
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City | COEUR D ALENE
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State | ID
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Zip | 83814-1013
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Country | US
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Telephone | 208-435-0788
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Fax |
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Provider Business Mailing Address
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Address Line | 1301 S CARNAHAN RD APT A408
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City | SPOKANE VALLEY
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State | WA
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Zip | 99212-3292
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Country | US
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Telephone |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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