Provider Demographics
NPI:1720623580
Name:DEMOND, KORREY LYNNE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KORREY
Middle Name:LYNNE
Last Name:DEMOND
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 1:15 CHIPPING STONE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02760-4485
Mailing Address - Country:US
Mailing Address - Phone:508-254-2354
Mailing Address - Fax:
Practice Address - Street 1:15 CHIPPING STONE RD
Practice Address - Street 2:
Practice Address - City:NORTH ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02760-4485
Practice Address - Country:US
Practice Address - Phone:508-254-2354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-15
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5726225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist