Provider Demographics
NPI:1154751352
Name:ERICKSON, EMILY GAIL (LMFT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:GAIL
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7362 UNIVERSITY AVE NE
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432-3142
Mailing Address - Country:US
Mailing Address - Phone:952-546-4044
Mailing Address - Fax:888-675-8262
Practice Address - Street 1:7362 UNIVERSITY AVE NE
Practice Address - Street 2:
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432-3142
Practice Address - Country:US
Practice Address - Phone:952-546-4044
Practice Address - Fax:888-675-8262
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-25
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2338106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist