Provider Demographics
NPI:1205036373
Name:KEATS, ERICA NAN KOREL (AUD)
Entity Type:Individual
Prefix:DR
First Name:ERICA
Middle Name:NAN KOREL
Last Name:KEATS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3204 TOWER OAKS BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4250
Mailing Address - Country:US
Mailing Address - Phone:301-315-0003
Mailing Address - Fax:301-315-0002
Practice Address - Street 1:3204 TOWER OAKS BLVD STE 400
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4250
Practice Address - Country:US
Practice Address - Phone:301-315-0003
Practice Address - Fax:301-315-0002
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2020-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00996231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist