Provider Demographics
NPI:1629239785
Name:CIORRA, KRISTIN ELIZABETH (MS OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:ELIZABETH
Last Name:CIORRA
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 HOWARD DR
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-8138
Mailing Address - Country:US
Mailing Address - Phone:516-712-5745
Mailing Address - Fax:
Practice Address - Street 1:508 AUTUMN SPRINGS CT
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-8272
Practice Address - Country:US
Practice Address - Phone:615-614-8833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-21
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014324225X00000X
TN7012225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist