Provider Demographics
NPI:1780981357
Name:ADAMS, ERICA SUZANE (DPT)
Entity type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:SUZANE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 GRANDIN AVE
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-2507
Mailing Address - Country:US
Mailing Address - Phone:410-775-5335
Mailing Address - Fax:
Practice Address - Street 1:497 RITCHIE HWY STE 1AB
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-2935
Practice Address - Country:US
Practice Address - Phone:410-775-5335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-17
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22570225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist