Provider Demographics
NPI:1548794738
Name:CARROW, ERICA CATHLYN (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:CATHLYN
Last Name:CARROW
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 1:816 MCKINLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62002-3357
Mailing Address - Country:US
Mailing Address - Phone:618-520-3073
Mailing Address - Fax:
Practice Address - Street 1:324 JUNGERMANN RD
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-5350
Practice Address - Country:US
Practice Address - Phone:636-928-5327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-14
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015033531225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics