National Provider Identifier
Jillian E Vine, CTRS
Jillian E Vine, CTRS is listed in the NPPES registry with a primary specialty of Recreation Therapist in Bath, NY and a listed phone number of (607) 664-4694.
Profile Overview
- NPI
- 1386354363
- Provider Type
- Individual
- Primary Specialty
- Recreation Therapist
- Enumeration Date
- November 30, 2022
- Last Updated
- November 30, 2022
Practice Location
- 76 Veterans Ave Bldg 92
- Bath, NY 14810-0810
Phone: (607) 664-4694
Mailing Address
- 160 Upper Delevan Ave
- Corning, NY 14830-3267
Specialties
- Recreation Therapist (225800000X)
Full Record
- NPI
- 1386354363
- Entity Type
- Individual
- Last Name
- Vine
- First Name
- Jillian
- Middle Name
- E
- Credential
- CTRS
- Mailing Street Address
- 160 Upper Delevan Ave
- Mailing City
- Corning
- Mailing State
- NY
- Mailing ZIP Code
- 14830-3267
- Mailing Country
- US
- Mailing Phone
- (607) 684-7506
- Practice Street Address
- 76 Veterans Ave Bldg 92
- Practice City
- Bath
- Practice State
- NY
- Practice ZIP Code
- 14810-0810
- Practice Country
- US
- Practice Phone
- (607) 664-4694
- Enumeration Date
- November 30, 2022
- Last Updated
- November 30, 2022
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- November 29, 2022
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Recreation Therapist (225800000X)