Provider Demographics
NPI:1538418074
Name:SPAIGHT, ERICA JOHNETTA
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:JOHNETTA
Last Name:SPAIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1283 HAISTAR TRAIL
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89441-3004
Mailing Address - Country:US
Mailing Address - Phone:775-830-3648
Mailing Address - Fax:775-322-6774
Practice Address - Street 1:1283 HAISTAR TRAIL
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89441-3004
Practice Address - Country:US
Practice Address - Phone:775-830-3648
Practice Address - Fax:775-322-6774
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst