Provider Demographics
NPI:1003131400
Name:BENNETT, CHRISTINA JOANNE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:JOANNE
Last Name:BENNETT
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12001 LONGHORN PKWY
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78732-1204
Mailing Address - Country:US
Mailing Address - Phone:512-266-5600
Mailing Address - Fax:
Practice Address - Street 1:12001 LONGHORN PKWY
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78732-1204
Practice Address - Country:US
Practice Address - Phone:512-266-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-29
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112101225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist