Provider Demographics
NPI:1508005810
Name:DANIELS, ERICKA RENEE
Entity Type:Individual
Prefix:
First Name:ERICKA
Middle Name:RENEE
Last Name:DANIELS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ERICKA
Other - Middle Name:RENEE
Other - Last Name:DILLON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:1728 SANDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-2634
Mailing Address - Country:US
Mailing Address - Phone:469-362-1096
Mailing Address - Fax:
Practice Address - Street 1:1728 SANDSTONE DR
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-2634
Practice Address - Country:US
Practice Address - Phone:469-362-1096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-10
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112956225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist