Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT2956 | ME |
N | 225XP0200X | Occupational Therapist - Pediatrics | OT2956 | ME |
NPI | 1043609860 |
---|---|
Provider Name | Renee D. Morin |
First Address | Bangor, ME 04401 |
Second Address | Bangor, ME 04401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2015 |
Last Update Date | 16/01/2015 |