Provider Demographics
NPI:1518992957
Name:LAPRELL, CORISSA LYNNE (MOT, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:CORISSA
Middle Name:LYNNE
Last Name:LAPRELL
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 CENTER ST
Mailing Address - Street 2:UNIT 6
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04210
Mailing Address - Country:US
Mailing Address - Phone:207-782-0333
Mailing Address - Fax:207-782-0333
Practice Address - Street 1:229 CENTER ST
Practice Address - Street 2:UNIT 6
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-6168
Practice Address - Country:US
Practice Address - Phone:207-782-0333
Practice Address - Fax:207-782-0333
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT1699225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME407800000OtherMAINECARE PROVIDER ID
MEOT1699OtherOCC.THERAPY LICENSE