Provider Demographics
NPI:1740621440
Name:HEWITT, ERIN L (COTA)
Entity type:Individual
Prefix:MISS
First Name:ERIN
Middle Name:L
Last Name:HEWITT
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 E WASHINGTON ST APT B
Mailing Address - Street 2:P.O. BOX 23 APT B
Mailing Address - City:UPLAND
Mailing Address - State:IN
Mailing Address - Zip Code:46989
Mailing Address - Country:US
Mailing Address - Phone:765-618-5715
Mailing Address - Fax:
Practice Address - Street 1:33 E WASHINGTON ST
Practice Address - Street 2:APT B
Practice Address - City:UPLAND
Practice Address - State:IN
Practice Address - Zip Code:46989
Practice Address - Country:US
Practice Address - Phone:765-618-5715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-10
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN32002454A224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant