Ericksen, Sally

Ericksen, Sally is an individual health care provider with primary practice located at 540 Kingsley Ave , Orange Park FL 32073-4847. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Ericksen, Sally can be contacted via phone (904) 264-2156.

Contact Information

Primary practice address
540 Kingsley Ave Orange Park FL 32073-4847
Phone: (904) 264-2156
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X OT77 Florida

Profile Details

NPI number 1750475083
LBN Legal business name Ericksen, Sally
Credentials Occupational Therapist (OT)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750475083 NPPES
Florida MEDICAID 8873658000

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