Provider Demographics
NPI:1003212192
Name:ROSE, ERIN WHITNEY (OTD, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:WHITNEY
Last Name:ROSE
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 GRACEY ST
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:TN
Mailing Address - Zip Code:38583-2046
Mailing Address - Country:US
Mailing Address - Phone:931-836-2211
Mailing Address - Fax:931-836-2230
Practice Address - Street 1:34 GRACEY ST
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:TN
Practice Address - Zip Code:38583-2046
Practice Address - Country:US
Practice Address - Phone:931-836-2211
Practice Address - Fax:931-836-2230
Is Sole Proprietor?:No
Enumeration Date:2014-11-17
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4248225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist