Provider Demographics
NPI:1861553752
Name:MULLER, ERICA MARIE (MT)
Entity type:Individual
Prefix:MS
First Name:ERICA
Middle Name:MARIE
Last Name:MULLER
Suffix:
Gender:F
Credentials:MT
Other - Prefix:MS
Other - First Name:ERICA
Other - Middle Name:MARIE
Other - Last Name:FRITSCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:31 MYRTLE ST
Mailing Address - Street 2:
Mailing Address - City:WAYMART
Mailing Address - State:PA
Mailing Address - Zip Code:18472-9133
Mailing Address - Country:US
Mailing Address - Phone:570-470-5661
Mailing Address - Fax:
Practice Address - Street 1:200 DELAWARE ST
Practice Address - Street 2:
Practice Address - City:HONESDALE
Practice Address - State:PA
Practice Address - Zip Code:18431-1150
Practice Address - Country:US
Practice Address - Phone:570-253-9039
Practice Address - Fax:570-253-9052
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist