Provider Demographics
NPI:1063259976
Name:FINE, ELIZABETH
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:FINE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:HODGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:878 LITTLE VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:TN
Mailing Address - Zip Code:37709-5054
Mailing Address - Country:US
Mailing Address - Phone:865-806-3915
Mailing Address - Fax:
Practice Address - Street 1:210 N HICKS ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:TN
Practice Address - Zip Code:37716-2920
Practice Address - Country:US
Practice Address - Phone:865-457-0616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics