Healthcare Provider Details

I. General information

NPI: 1467433482
Provider Name (Legal Business Name): ERIN M NOLAN OTRL
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 N WASHINGTON ST
WILMINGTON DE
19802-4722
US

IV. Provider business mailing address

1201 GILPIN AVE
WILMINGTON DE
19806-3107
US

V. Phone/Fax

Practice location:
  • Phone: 302-656-2684
  • Fax: 302-656-0292
Mailing address:
  • Phone: 302-628-5927
  • Fax: 302-656-0292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberU1-0000881
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: