Provider Demographics
NPI:1811241367
Name:HILL, ERICA BEVERLY (OT)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:BEVERLY
Last Name:HILL
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:R
Other - Last Name:BEVERLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:575 ROLAND MANOR DRIVE
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019
Mailing Address - Country:US
Mailing Address - Phone:404-234-5205
Mailing Address - Fax:
Practice Address - Street 1:575 ROLAND MANOR DR
Practice Address - Street 2:
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-6584
Practice Address - Country:US
Practice Address - Phone:404-531-8590
Practice Address - Fax:404-531-8581
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-06
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT004239225X00000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist