Provider Demographics
NPI:1104682905
Name:O'LEARY, ERIN ROSE (CTRS)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:ROSE
Last Name:O'LEARY
Suffix:
Gender:F
Credentials:CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39150 CITATION PL APT 34104
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-4900
Mailing Address - Country:US
Mailing Address - Phone:248-345-4534
Mailing Address - Fax:
Practice Address - Street 1:39150 CITATION PL APT 34104
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-4900
Practice Address - Country:US
Practice Address - Phone:248-345-4534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist