MEDICARE: ERIKA R WEISS MOT, OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	09-0069	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932204120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIKA R WEISS MOT, OTR/L

Provider Business Mailing Address
First Line	:	9160 TUDOR PARK PL
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-8725
Country	:	US
Telephone Number	:	954-243-3290
Fax Number	:

Provider Business Practice Location Address
First Line	:	3030 S JONES BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-6792
Country	:	US
Telephone Number	:	954-243-3290
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	12/15/2011

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