Provider Demographics
NPI:1619423696
Name:SALRIN, KRISTINA MARIE
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:MARIE
Last Name:SALRIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 LAKE ERIE ST
Mailing Address - Street 2:
Mailing Address - City:CONNEAUT
Mailing Address - State:OH
Mailing Address - Zip Code:44030-1358
Mailing Address - Country:US
Mailing Address - Phone:440-319-8476
Mailing Address - Fax:
Practice Address - Street 1:613 LAKE ERIE ST
Practice Address - Street 2:
Practice Address - City:CONNEAUT
Practice Address - State:OH
Practice Address - Zip Code:44030-1358
Practice Address - Country:US
Practice Address - Phone:440-319-8476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-30
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA.06511224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant