Provider Demographics
NPI:1235721580
Name:SCANLON, ERIN (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:SCANLON
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4327 HARRISON ST NW APT 1
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-2120
Mailing Address - Country:US
Mailing Address - Phone:301-806-6145
Mailing Address - Fax:
Practice Address - Street 1:5647 GULF DR
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-4019
Practice Address - Country:US
Practice Address - Phone:727-967-3025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-08
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT219832080P0006X, 225XP0200X
DCOT010001798225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
438254OtherNATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY
DCOT010001798OtherDC DOH BOARD OF OCCUPATIONAL THERAPY
FLOT21983OtherFLORIDA BOARD OF OCCUPATIONAL THERAPY