Provider Demographics
NPI:1316271372
Name:RAMPANT, ERICA (OTR/L)
Entity type:Individual
Prefix:MISS
First Name:ERICA
Middle Name:
Last Name:RAMPANT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:
Other - Last Name:BRUSCKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L IBCLC
Mailing Address - Street 1:3972 MAIDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-7577
Mailing Address - Country:US
Mailing Address - Phone:973-476-9831
Mailing Address - Fax:
Practice Address - Street 1:3972 MAIDSTONE DR
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-7577
Practice Address - Country:US
Practice Address - Phone:973-476-9831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2023-01-05
Deactivation Date:2010-09-01
Deactivation Code:
Reactivation Date:2011-12-29
Provider Licenses
StateLicense IDTaxonomies
MD06119225X00000X
DCOT010000866225X00000X
SC5240225XP0200X
VAL-308324174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics