Provider Demographics
NPI:1033575915
Name:HOWELL, CRISTINA (PTA)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:HOWELL
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:CRISTINA
Other - Middle Name:
Other - Last Name:PRACILIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:33900 HARPER AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-4258
Mailing Address - Country:US
Mailing Address - Phone:586-416-9100
Mailing Address - Fax:586-416-9103
Practice Address - Street 1:15400 NORTHLINE RD
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195-2689
Practice Address - Country:US
Practice Address - Phone:734-285-0100
Practice Address - Fax:734-285-0101
Is Sole Proprietor?:No
Enumeration Date:2016-01-08
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5502004756225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant