Provider Demographics
NPI:1912456922
Name:LEVINE, CORINNA SIMONE (OTR)
Entity Type:Individual
Prefix:
First Name:CORINNA
Middle Name:SIMONE
Last Name:LEVINE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:CORINNA
Other - Middle Name:SIMONE
Other - Last Name:KLINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2031 CLYDE FALLS DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-4689
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2031 CLYDE FALLS DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-4689
Practice Address - Country:US
Practice Address - Phone:713-725-6354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-03
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117497225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics