Provider Demographics
NPI:1033703327
Name:STALLINGS, CHRISTIAN TAYLOR (OTR/L)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:TAYLOR
Last Name:STALLINGS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:CHRISTIAN
Other - Middle Name:TAYLOR
Other - Last Name:DIFRUSCIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:7364 RIVER PINE DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-5243
Mailing Address - Country:US
Mailing Address - Phone:804-517-1154
Mailing Address - Fax:
Practice Address - Street 1:10124 W BROAD ST STE P
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-3330
Practice Address - Country:US
Practice Address - Phone:804-273-6656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-26
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119008255225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics