Provider Demographics
NPI:1427764141
Name:ERWIN, ALICIA N
Entity type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:N
Last Name:ERWIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:N
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7337 RUSKIN RD APT 2
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19151-2204
Mailing Address - Country:US
Mailing Address - Phone:215-796-7307
Mailing Address - Fax:
Practice Address - Street 1:7337 RUSKIN RD APT 2
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19151-2204
Practice Address - Country:US
Practice Address - Phone:215-796-7307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty