Healthcare Provider Details

I. General information

NPI: 1568917177
Provider Name (Legal Business Name): ERIN ROSE BABINEAU PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2016
Last Update Date: 06/21/2021
Certification Date: 06/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1939 MINNEHAHA AVE W STE 100
SAINT PAUL MN
55104-1033
US

IV. Provider business mailing address

1830 HANLEY RD
HUDSON WI
54016-9368
US

V. Phone/Fax

Practice location:
  • Phone: 651-348-7428
  • Fax: 651-348-7432
Mailing address:
  • Phone: 715-386-1155
  • Fax: 715-386-1105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number13608
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number10371
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: