Provider Demographics
NPI:1154727576
Name:MORRIS, MINDI ELLEN (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:MINDI
Middle Name:ELLEN
Last Name:MORRIS
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 1:1392 ALBANY POST RD
Mailing Address - Street 2:
Mailing Address - City:CROTON ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10520-1559
Mailing Address - Country:US
Mailing Address - Phone:914-816-8969
Mailing Address - Fax:
Practice Address - Street 1:43 TANTON HILL RD
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-3207
Practice Address - Country:US
Practice Address - Phone:203-438-2920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-12
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003032-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist