Provider Demographics
NPI:1952970345
Name:WATERS, ERIN ELIZABETH (OTR/L)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:ELIZABETH
Last Name:WATERS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 CHARLES VIEW WAY APT A
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2113
Mailing Address - Country:US
Mailing Address - Phone:410-937-0757
Mailing Address - Fax:
Practice Address - Street 1:11 KELLER RD
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-1308
Practice Address - Country:US
Practice Address - Phone:410-415-5260
Practice Address - Fax:410-415-5261
Is Sole Proprietor?:No
Enumeration Date:2021-06-21
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09661225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist