Provider Demographics
NPI:1215683008
Name:SCANTLIN, ERIN M (COTA)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:M
Last Name:SCANTLIN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 344
Mailing Address - Street 2:
Mailing Address - City:BLANCHARD
Mailing Address - State:LA
Mailing Address - Zip Code:71009-0344
Mailing Address - Country:US
Mailing Address - Phone:318-393-7223
Mailing Address - Fax:
Practice Address - Street 1:5296 PINE HILL RD
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71107-2408
Practice Address - Country:US
Practice Address - Phone:318-393-7223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA329923224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant