Provider Demographics
NPI:1316227119
Name:BLUE, TINA RUTH (OTR)
Entity Type:Individual
Prefix:MRS
First Name:TINA
Middle Name:RUTH
Last Name:BLUE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7260 SEA CLIFF VILLAS
Mailing Address - Street 2:UNIT 35
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00802-2700
Mailing Address - Country:US
Mailing Address - Phone:340-626-2960
Mailing Address - Fax:
Practice Address - Street 1:7260 SEA CLIFF VILLAS
Practice Address - Street 2:UNIT 35
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-2700
Practice Address - Country:US
Practice Address - Phone:340-626-2960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-24
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist