Provider Demographics
NPI:1386794964
Name:TRIPLETT, ERIN NIQUANE (COTA-L)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:NIQUANE
Last Name:TRIPLETT
Suffix:
Gender:F
Credentials:COTA-L
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:NIQUANE
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:535 CHIPLEY RD
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:MS
Mailing Address - Zip Code:39051-9047
Mailing Address - Country:US
Mailing Address - Phone:601-267-0433
Mailing Address - Fax:
Practice Address - Street 1:711 AVIGNON DR
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-5120
Practice Address - Country:US
Practice Address - Phone:601-605-6777
Practice Address - Fax:601-605-8869
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSTA1598224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant