Provider Demographics
NPI:1427396753
Name:GAURIN, WILLIAM J (OTR/L)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:J
Last Name:GAURIN
Suffix:
Gender:M
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 1:70 RICHARD AVE
Mailing Address - Street 2:
Mailing Address - City:SEVERN
Mailing Address - State:MD
Mailing Address - Zip Code:21144-3350
Mailing Address - Country:US
Mailing Address - Phone:443-889-2356
Mailing Address - Fax:
Practice Address - Street 1:70 RICHARD AVE
Practice Address - Street 2:
Practice Address - City:SEVERN
Practice Address - State:MD
Practice Address - Zip Code:21144-3350
Practice Address - Country:US
Practice Address - Phone:443-889-2356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05704225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist