Provider Demographics
NPI:1376571661
Name:VARN, KRISTIN (MSR, OTR/L)
Entity Type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:
Last Name:VARN
Suffix:
Gender:F
Credentials:MSR, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1437 WATERS EDGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29492
Mailing Address - Country:US
Mailing Address - Phone:843-442-1057
Mailing Address - Fax:843-388-2627
Practice Address - Street 1:1437 WATERS EDGE DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29492-8012
Practice Address - Country:US
Practice Address - Phone:843-442-1057
Practice Address - Fax:843-388-2627
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2690225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCTH1702Medicaid