Provider Demographics
NPI:1780066928
Name:MORIN, KIM MARIE (OT/L)
Entity type:Individual
Prefix:MRS
First Name:KIM
Middle Name:MARIE
Last Name:MORIN
Suffix:
Gender:F
Credentials:OT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 MAINE ST
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-3310
Mailing Address - Country:US
Mailing Address - Phone:207-373-2293
Mailing Address - Fax:207-373-2197
Practice Address - Street 1:329 MAINE ST
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-3310
Practice Address - Country:US
Practice Address - Phone:207-373-2293
Practice Address - Fax:207-373-2197
Is Sole Proprietor?:No
Enumeration Date:2015-06-24
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT1305174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist