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General NPI Number Information
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NPI Number | 1972339802
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Entity Type | Individual
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Provider Name | LAUREN ERICKSON
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Gender | Female
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Dates
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Enumeration Date | 09/09/2024
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 471 MAGNOLIA AVE E
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City | SAINT PAUL
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State | MN
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Zip | 55130-3849
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Country | US
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Telephone | 651-776-5151
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Fax |
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Provider Business Mailing Address
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Address Line | 2114 150TH LN NW
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City | ANDOVER
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State | MN
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Zip | 55304-2569
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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 | 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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