Provider Demographics
NPI:1275697153
Name:MORIN, CLAUDIA THERESA (OTR)
Entity Type:Individual
Prefix:MS
First Name:CLAUDIA
Middle Name:THERESA
Last Name:MORIN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:987 REYNOLDS FARM RD
Mailing Address - Street 2:P.O. BOX 828
Mailing Address - City:GROVETOWN
Mailing Address - State:GA
Mailing Address - Zip Code:30813-4835
Mailing Address - Country:US
Mailing Address - Phone:706-854-0644
Mailing Address - Fax:706-854-0644
Practice Address - Street 1:987 REYNOLDS FARM RD
Practice Address - Street 2:
Practice Address - City:GROVETOWN
Practice Address - State:GA
Practice Address - Zip Code:30813-4835
Practice Address - Country:US
Practice Address - Phone:706-854-0644
Practice Address - Fax:706-854-0644
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT000244225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA354744OtherWELLCARE
GA10040564OtherAMERIGROUP
GA308513OtherWELLCARE