Provider Demographics
NPI:1982154431
Name:HALEY, ERIKA (OTR/L)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:HALEY
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 1:6034 RICHMOND HWY APT 605
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22303-2112
Mailing Address - Country:US
Mailing Address - Phone:571-882-0652
Mailing Address - Fax:
Practice Address - Street 1:14507 SAINT GREGORY WAY
Practice Address - Street 2:
Practice Address - City:ACCOKEEK
Practice Address - State:MD
Practice Address - Zip Code:20607-2927
Practice Address - Country:US
Practice Address - Phone:301-882-8511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-08
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT006520225X00000X
DCOT010001302225X00000X
MD08649225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist