Healthcare Provider Details

I. General information

NPI: 1811796832
Provider Name (Legal Business Name): ERIN MARIE ARBOUR
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2025
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3270 SUNTREE BLVD STE 103A
MELBOURNE FL
32940-7540
US

IV. Provider business mailing address

776 CAVALIER DR APT F
INDIALANTIC FL
32903-2052
US

V. Phone/Fax

Practice location:
  • Phone: 321-757-4015
  • Fax:
Mailing address:
  • Phone: 773-834-6989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number27490
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: