Provider Demographics
NPI:1710391388
Name:MORALES, ERIKA (COTA/L)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109B BROADMEADOW ST
Mailing Address - Street 2:APT 2
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-3466
Mailing Address - Country:US
Mailing Address - Phone:774-462-2075
Mailing Address - Fax:
Practice Address - Street 1:109B BROADMEADOW ST
Practice Address - Street 2:APT 2
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-3466
Practice Address - Country:US
Practice Address - Phone:774-462-2075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA900001941224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant