Provider Demographics
NPI:1083857403
Name:CAMPBELL, ERIKA MINES (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:ERIKA
Middle Name:MINES
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6368 COVENTRY WAY STE 363
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-2256
Mailing Address - Country:US
Mailing Address - Phone:301-237-9523
Mailing Address - Fax:888-242-8040
Practice Address - Street 1:13228 HAMPTON FARM LN
Practice Address - Street 2:
Practice Address - City:BRANDYWINE
Practice Address - State:MD
Practice Address - Zip Code:20613-5811
Practice Address - Country:US
Practice Address - Phone:301-237-9523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-15
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05814225X00000X, 171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No171W00000XOther Service ProvidersContractor