Provider Demographics
NPI:1770094211
Name:LAWSON, ERIN RYAN (PSYS, LLP)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:RYAN
Last Name:LAWSON
Suffix:
Gender:F
Credentials:PSYS, LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7029 PENINSULA CT
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-1990
Mailing Address - Country:US
Mailing Address - Phone:248-892-1491
Mailing Address - Fax:
Practice Address - Street 1:6887 DIXIE HWY STE A
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-5107
Practice Address - Country:US
Practice Address - Phone:248-620-1019
Practice Address - Fax:248-620-1026
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-23
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301011530103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical