Provider Demographics
NPI:1467626903
Name:BURNS, ERICA (OTR, OT/L)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:BURNS
Suffix:
Gender:F
Credentials:OTR, OT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6306 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-1549
Mailing Address - Country:US
Mailing Address - Phone:602-279-5801
Mailing Address - Fax:602-279-0033
Practice Address - Street 1:6306 N 7TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-1549
Practice Address - Country:US
Practice Address - Phone:602-279-5801
Practice Address - Fax:602-279-0033
Is Sole Proprietor?:No
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4083225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics