Provider Demographics
NPI:1699081265
Name:MOUSER, ERICA NICOLE (MOT/L)
Entity type:Individual
Prefix:MS
First Name:ERICA
Middle Name:NICOLE
Last Name:MOUSER
Suffix:
Gender:F
Credentials:MOT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 SUNBIRD CT
Mailing Address - Street 2:
Mailing Address - City:RIVESVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26588-9300
Mailing Address - Country:US
Mailing Address - Phone:304-614-2226
Mailing Address - Fax:
Practice Address - Street 1:1712 LOCUST AVE
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-1321
Practice Address - Country:US
Practice Address - Phone:681-404-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-20
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1491225XP0200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics