Provider Demographics
NPI:1003400771
Name:HYLAND, CHRISTINA (OTR/L)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:HYLAND
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 1:2929 N 70TH ST APT 3062
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6374
Mailing Address - Country:US
Mailing Address - Phone:847-971-7193
Mailing Address - Fax:
Practice Address - Street 1:4641 N 12TH ST STE 100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-4085
Practice Address - Country:US
Practice Address - Phone:602-281-2896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-23
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTH-008342225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist