Provider Demographics
NPI:1659120202
Name:MORIN, CAMILLE DIANE
Entity type:Individual
Prefix:MRS
First Name:CAMILLE
Middle Name:DIANE
Last Name:MORIN
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 1:6116 NW 20TH CT
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-2319
Mailing Address - Country:US
Mailing Address - Phone:786-671-2802
Mailing Address - Fax:
Practice Address - Street 1:6116 NW 20TH CT
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-2319
Practice Address - Country:US
Practice Address - Phone:786-671-2802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL228191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical