Provider Demographics
NPI:1598071375
Name:EADES, ERIKA L (OT)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:L
Last Name:EADES
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14409 GREENVIEW DR
Mailing Address - Street 2:STE 102
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-3293
Mailing Address - Country:US
Mailing Address - Phone:301-498-8100
Mailing Address - Fax:301-498-0009
Practice Address - Street 1:3800 LOTTSFORD VISTA RD
Practice Address - Street 2:
Practice Address - City:MITCHELLVILLE
Practice Address - State:MD
Practice Address - Zip Code:20721-4018
Practice Address - Country:US
Practice Address - Phone:301-459-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-31
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06205225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist