Provider Demographics
NPI:1134618069
Name:EATON, RUTH HELEN
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:HELEN
Last Name:EATON
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:PO BOX 658
Mailing Address - Street 2:
Mailing Address - City:CASTINE
Mailing Address - State:ME
Mailing Address - Zip Code:04421-0658
Mailing Address - Country:US
Mailing Address - Phone:207-610-0620
Mailing Address - Fax:
Practice Address - Street 1:587 N DEER ISLE RD
Practice Address - Street 2:
Practice Address - City:DEER ISLE
Practice Address - State:ME
Practice Address - Zip Code:04627-3438
Practice Address - Country:US
Practice Address - Phone:207-348-2351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-07
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT3400225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist