Provider Demographics
NPI:1003251760
Name:WETHERILL-OCHOA, ERIN (CM II, CPRP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:WETHERILL-OCHOA
Suffix:
Gender:F
Credentials:CM II, CPRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35168 EW 1400
Mailing Address - Street 2:
Mailing Address - City:KONAWA
Mailing Address - State:OK
Mailing Address - Zip Code:74849-6025
Mailing Address - Country:US
Mailing Address - Phone:580-399-5647
Mailing Address - Fax:
Practice Address - Street 1:35168 EW 1400
Practice Address - Street 2:
Practice Address - City:KONAWA
Practice Address - State:OK
Practice Address - Zip Code:74849-6025
Practice Address - Country:US
Practice Address - Phone:580-399-5647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-07
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator