Provider Demographics
NPI:1144643586
Name:MORIN, NICOLE (MS OTR/L)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:MORIN
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 BAILEY ST
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-6302
Mailing Address - Country:US
Mailing Address - Phone:401-374-2771
Mailing Address - Fax:
Practice Address - Street 1:180 BAILEY ST
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-6302
Practice Address - Country:US
Practice Address - Phone:401-374-2771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-21
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10400314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility