Provider Demographics
NPI:1033346283
Name:TAIT, KRISTINE M (MOT, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINE
Middle Name:M
Last Name:TAIT
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:KRISTINE
Other - Middle Name:M
Other - Last Name:KREBS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOT, OTR/L
Mailing Address - Street 1:890 BEAVER GRADE RD
Mailing Address - Street 2:
Mailing Address - City:MOON TWP
Mailing Address - State:PA
Mailing Address - Zip Code:15108-2653
Mailing Address - Country:US
Mailing Address - Phone:412-474-3566
Mailing Address - Fax:412-474-3575
Practice Address - Street 1:890 BEAVER GRADE RD
Practice Address - Street 2:
Practice Address - City:MOON TWP
Practice Address - State:PA
Practice Address - Zip Code:15108-2653
Practice Address - Country:US
Practice Address - Phone:412-474-3566
Practice Address - Fax:412-474-3575
Is Sole Proprietor?:No
Enumeration Date:2009-06-15
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC009454225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist