Provider Demographics
NPI:1821414673
Name:COOLEY, ERIKA KATHRYN (OTR/L)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:KATHRYN
Last Name:COOLEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:KATHRYN
Other - Last Name:SHELTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:1545 SILVER ST
Mailing Address - Street 2:
Mailing Address - City:HERMOSA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90254-3348
Mailing Address - Country:US
Mailing Address - Phone:404-285-1329
Mailing Address - Fax:
Practice Address - Street 1:1545 SILVER ST
Practice Address - Street 2:
Practice Address - City:HERMOSA BEACH
Practice Address - State:CA
Practice Address - Zip Code:90254-3348
Practice Address - Country:US
Practice Address - Phone:404-285-1329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-17
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10487225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist