Provider Demographics
NPI:1699975045
Name:AYANAW, ERIKA LYNN (EDS)
Entity type:Individual
Prefix:MRS
First Name:ERIKA
Middle Name:LYNN
Last Name:AYANAW
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:LYNN
Other - Last Name:REDMOND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2321 CHEMIN AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-5019
Mailing Address - Country:US
Mailing Address - Phone:314-322-6085
Mailing Address - Fax:
Practice Address - Street 1:2321 CHEMIN AVE
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-5019
Practice Address - Country:US
Practice Address - Phone:314-322-6085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLPC-1894T101YP2500X
CA190235003103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional