Provider Demographics
NPI:1699019851
Name:CAPINPIN, CONNIE SOMIDO (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:CONNIE
Middle Name:SOMIDO
Last Name:CAPINPIN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2675 COURT DR
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-1478
Mailing Address - Country:US
Mailing Address - Phone:704-824-7800
Mailing Address - Fax:704-824-3999
Practice Address - Street 1:205 E COUNCIL ST
Practice Address - Street 2:SUITE C
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-5080
Practice Address - Country:US
Practice Address - Phone:704-636-3334
Practice Address - Fax:704-639-0070
Is Sole Proprietor?:No
Enumeration Date:2012-11-11
Last Update Date:2012-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6314225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist