Boutin, Kevin
Boutin, Kevin is an sole proprietor health care provider with primary practice located at 90 Clark Ave # A , Tupelo MS 38804-2801. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as his primary health care specialty. Boutin, Kevin can be contacted via phone (662) 840-0535.Contact Information
Primary practice address
90 Clark Ave # A
Tupelo MS 38804-2801
Phone: (662) 840-0535
Fax: (662) 842-7915
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | OT1239 | Mississippi |
Profile Details
| NPI number | 1780740456 |
|---|---|
| LBN Legal business name | Boutin, Kevin |
| Credentials | Occupational Therapist (OT) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 28th, 2006 |
| Last updated | Jul 9th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780740456 | NPPES |
| Mississippi | MEDICAID | 00123797 |
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