Provider Demographics
NPI:1093046922
Name:MCKIM, CHRISTI DANIELLE (MS, OTR/L, ATP)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTI
Middle Name:DANIELLE
Last Name:MCKIM
Suffix:
Gender:F
Credentials:MS, OTR/L, ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 FRANCK AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-2544
Mailing Address - Country:US
Mailing Address - Phone:812-596-0116
Mailing Address - Fax:
Practice Address - Street 1:11003 BLUEGRASS PKWY STE 460
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-2392
Practice Address - Country:US
Practice Address - Phone:502-266-5213
Practice Address - Fax:800-809-5213
Is Sole Proprietor?:No
Enumeration Date:2010-01-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY164536225XG0600X
225XP0200X
IN31004237A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics