Sally Ericksen, OT
Occupational Therapist in Orange Park, FL. Individual provider (NPI-1).
NPI number1750475083
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1750475083
- Entity type
- Individual (NPI-1)
- Name
- Sally Ericksen
- Credential
- OT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 3, 2006
- Last updated
- Jul 8, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225X00000X | Occupational Therapist | OT77 | FL | Yes |
Practice location
540 Kingsley AveOrange Park, FL 32073-4847
Phone 904-264-2156
Mailing address
2194 Lakeside Dr EFernandina Beach, FL 32034-5232
Phone 904-261-2329
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 47 Occupational Therapist providers in Orange Park · All 2,903 providers in Orange Park
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