Provider Demographics
NPI:1093012627
Name:LEWANDOWSKI, CHRISTINE L (OTR/L)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:L
Last Name:LEWANDOWSKI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 N BRADLEY HWY
Mailing Address - Street 2:SUITE C
Mailing Address - City:ROGERS CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49779-1539
Mailing Address - Country:US
Mailing Address - Phone:989-734-7545
Mailing Address - Fax:989-737-7648
Practice Address - Street 1:555 N BRADLEY HWY
Practice Address - Street 2:SUITE C
Practice Address - City:ROGERS CITY
Practice Address - State:MI
Practice Address - Zip Code:49779-1539
Practice Address - Country:US
Practice Address - Phone:989-734-7545
Practice Address - Fax:989-737-7648
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-17
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201007560225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5201007560OtherOCCUPATIONAL THERAPIST LICENSE