Provider Demographics
NPI:1881006476
Name:FINE, ERIN
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:FINE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3858 SE JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-5453
Mailing Address - Country:US
Mailing Address - Phone:772-634-0733
Mailing Address - Fax:
Practice Address - Street 1:3858 SE JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-5453
Practice Address - Country:US
Practice Address - Phone:772-634-0733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-29
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist