Provider Demographics
NPI:1043518434
Name:HILL, KARISSA MICHELLE (OTR)
Entity Type:Individual
Prefix:
First Name:KARISSA
Middle Name:MICHELLE
Last Name:HILL
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 1:2003 IRON HORSE CT
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-4411
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:99 REGENCY PKWY
Practice Address - Street 2:SUITE 313
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-7817
Practice Address - Country:US
Practice Address - Phone:888-864-3572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-08
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114040225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics