Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 4248 | TN |
NPI | 1003212192 |
---|---|
Provider Name | Dr. Erin Whitney Rose |
First Address | Sparta, TN 38583-2046 |
Second Address | Sparta, TN 38583-2046 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2014 |
Last Update Date | 17/11/2014 |