Provider Demographics
NPI:1235652900
Name:GOOD, ERICA (OTR/L)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:GOOD
Suffix:
Gender:
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2980 CENTREVILLE RD
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171-6254
Mailing Address - Country:US
Mailing Address - Phone:571-449-6983
Mailing Address - Fax:
Practice Address - Street 1:2980 CENTREVILLE RD
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20171-6254
Practice Address - Country:US
Practice Address - Phone:571-449-6983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-25
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08224225X00000X
VA0119008796225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist