Provider Demographics
NPI:1104681212
Name:MAURO, ERIKA A (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:A
Last Name:MAURO
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 HICKORY RD
Mailing Address - Street 2:
Mailing Address - City:FELL TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18407-2815
Mailing Address - Country:US
Mailing Address - Phone:570-430-0685
Mailing Address - Fax:
Practice Address - Street 1:15 HICKORY RD
Practice Address - Street 2:
Practice Address - City:FELL TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18407-2815
Practice Address - Country:US
Practice Address - Phone:570-430-0685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC008304225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics