Provider Demographics
NPI:1033392089
Name:DORIN, RAQUEL N (PT)
Entity Type:Individual
Prefix:MISS
First Name:RAQUEL
Middle Name:N
Last Name:DORIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 ACOYTE
Mailing Address - Street 2:8 F
Mailing Address - City:BUENOS AIRES
Mailing Address - State:BUENOS AIRES
Mailing Address - Zip Code:1405
Mailing Address - Country:AR
Mailing Address - Phone:4-903-6711
Mailing Address - Fax:
Practice Address - Street 1:2716 LIBERTY
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604
Practice Address - Country:US
Practice Address - Phone:989-792-6016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-13
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501011623225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist