Provider Demographics
NPI:1730208968
Name:ERICKSON, KAREN (OT)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:ERICKSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OT
Mailing Address - Street 1:2216 LAKE POINTE CIR
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-9580
Mailing Address - Country:US
Mailing Address - Phone:352-728-1230
Mailing Address - Fax:
Practice Address - Street 1:2216 LAKE POINTE CIR
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-9580
Practice Address - Country:US
Practice Address - Phone:352-409-1230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA9815282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital