| Randi L. Erickson | |
|
2910 Enloe St Suite 104 Hudson WI 54016-4538 | |
| (715) 377-0000 | |
| (715) 377-0010 |
| Full Name | Randi L. Erickson |
|---|---|
| Speciality | Psychologist |
| Location | 2910 Enloe St, Hudson, Wisconsin |
| Authorized Official Name and Position | Randi L Erickson (OWNER) |
| Authorized Official Contact | 7153770000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Randi L. Erickson 2910 Enloe St Suite 104 Hudson WI 54016-4538 Ph: (715) 377-0000 | Randi L. Erickson 2910 Enloe St Suite 104 Hudson WI 54016-4538 Ph: (715) 377-0000 |
| NPI Number | 1376659201 |
|---|---|
| Provider Enumeration Date | 08/22/2006 |
| Last Update Date | 07/10/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376659201 | NPI | - | NPPES |
| 1689778748 | Other | WI | INDIVIDUAL NPI NUMBER |
| 39147000 | Medicaid | WI | |
| 1689778748 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Secondary |
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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