Provider Demographics
NPI:1356138077
Name:PARKS, ERICA DANIELLE
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:DANIELLE
Last Name:PARKS
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 1:1143 ROBIN CT
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-2651
Mailing Address - Country:US
Mailing Address - Phone:220-221-1012
Mailing Address - Fax:220-221-1012
Practice Address - Street 1:1143 ROBIN CT
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-2651
Practice Address - Country:US
Practice Address - Phone:220-221-1012
Practice Address - Fax:220-221-1012
Is Sole Proprietor?:No
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPS.006166175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist