Provider Demographics
NPI:1245829811
Name:COLE, ERIKA LYNNE
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:LYNNE
Last Name:COLE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1256 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-6727
Mailing Address - Country:US
Mailing Address - Phone:585-794-8714
Mailing Address - Fax:
Practice Address - Street 1:5113 PIPER STATION DR STE 103
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-6690
Practice Address - Country:US
Practice Address - Phone:704-752-1616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-18
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24037225X00000X
MO2024019915225X00000X
TX121280225X00000X
NC17379225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist