Provider Demographics
NPI:1033591698
Name:MOINAT, KORINNE (OTR/L)
Entity Type:Individual
Prefix:
First Name:KORINNE
Middle Name:
Last Name:MOINAT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1589 S FOREST ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-3831
Mailing Address - Country:US
Mailing Address - Phone:720-420-7611
Mailing Address - Fax:
Practice Address - Street 1:1589 S FOREST ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-3831
Practice Address - Country:US
Practice Address - Phone:720-420-7611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-19
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0004150225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist