Individual provider · Type 1 NPI
Amy Marie Ericksen, D.T.
Developmental Therapist · Cherry Valley, IL
Practice location
3718 Gnarl Tree Ln
Cherry Valley, IL 61016-9678
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Developmental Therapist Primary | 222Q00000X | AE05370202P (IL) |
Developmental Therapist: A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Deve…
About NPI 1982808077
Amy Marie Ericksen, D.T.'s National Provider Identifier is 1982808077, issued on Jun 12, 2007. The primary taxonomy on file is Developmental Therapist (222Q00000X), and the practice location is in Cherry Valley, IL. The record was last updated on Jul 8, 2007.