Provider Demographics
NPI:1952706327
Name:GORMLEY, ERIN
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:GORMLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:373 WALNUT TRL
Mailing Address - Street 2:
Mailing Address - City:CROWNSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21032-1732
Mailing Address - Country:US
Mailing Address - Phone:410-305-9120
Mailing Address - Fax:410-571-0030
Practice Address - Street 1:373 WALNUT TRL
Practice Address - Street 2:
Practice Address - City:CROWNSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21032-1732
Practice Address - Country:US
Practice Address - Phone:410-305-9120
Practice Address - Fax:410-571-0030
Is Sole Proprietor?:No
Enumeration Date:2014-10-28
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02771225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist