Provider Demographics
NPI:1831697143
Name:ST. PIERRE, ERIN LYNN (PTA)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:LYNN
Last Name:ST. PIERRE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 N UPPER NARROWS LN
Mailing Address - Street 2:
Mailing Address - City:WINTHROP
Mailing Address - State:ME
Mailing Address - Zip Code:04364-3614
Mailing Address - Country:US
Mailing Address - Phone:207-446-6965
Mailing Address - Fax:
Practice Address - Street 1:7 REED ST
Practice Address - Street 2:
Practice Address - City:HALLOWELL
Practice Address - State:ME
Practice Address - Zip Code:04347-3047
Practice Address - Country:US
Practice Address - Phone:207-622-6351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-01
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPA4941225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant