Provider Demographics
NPI:1053681379
Name:PRIGGE, CHRISTINE ROSE (OT)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ROSE
Last Name:PRIGGE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 W PARKWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-6434
Mailing Address - Country:US
Mailing Address - Phone:480-707-7537
Mailing Address - Fax:
Practice Address - Street 1:621 N TERCERA AVE
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-4072
Practice Address - Country:US
Practice Address - Phone:480-239-1595
Practice Address - Fax:480-855-3507
Is Sole Proprietor?:No
Enumeration Date:2012-01-03
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4029225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist