Provider Demographics
NPI:1144614405
Name:PHILLIP, CHRISTINA (MS, OTR/L)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:
Last Name:PHILLIP
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3025 NOBLE AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23222-2525
Mailing Address - Country:US
Mailing Address - Phone:646-251-9562
Mailing Address - Fax:
Practice Address - Street 1:3025 NOBLE AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23222-2525
Practice Address - Country:US
Practice Address - Phone:646-251-9562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-25
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019572225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist