Provider Demographics
NPI:1467608281
Name:SNOW, ERIKA NICOLE (COTA/A)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:NICOLE
Last Name:SNOW
Suffix:
Gender:F
Credentials:COTA/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 SILVER OAK CT
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-4012
Mailing Address - Country:US
Mailing Address - Phone:912-748-3531
Mailing Address - Fax:
Practice Address - Street 1:815 E 63RD ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4420
Practice Address - Country:US
Practice Address - Phone:912-352-8615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000318224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant