Provider Demographics
NPI:1154812642
Name:CRIPE, ERIKA BENNETT (LMT)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:BENNETT
Last Name:CRIPE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:697 JASPER DR
Mailing Address - Street 2:
Mailing Address - City:FRUITA
Mailing Address - State:CO
Mailing Address - Zip Code:81521-8314
Mailing Address - Country:US
Mailing Address - Phone:405-255-1279
Mailing Address - Fax:
Practice Address - Street 1:2231 N 7TH ST STE 14
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-7434
Practice Address - Country:US
Practice Address - Phone:970-640-7682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-21
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT0021497225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist