Provider Demographics
NPI:1639756885
Name:ROBINSON, ERICA ASHLEY (LMT)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:ASHLEY
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:641 LAKESHORE VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70461-5696
Mailing Address - Country:US
Mailing Address - Phone:504-345-0813
Mailing Address - Fax:
Practice Address - Street 1:641 LAKESHORE VILLAGE DR
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70461-5696
Practice Address - Country:US
Practice Address - Phone:504-345-0813
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8470225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist