Provider Demographics
NPI:1154674679
Name:NGUYEN, KRISTI (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:
Last Name:NGUYEN
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 1:421 HOPE ST
Mailing Address - Street 2:UNIT E
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06906-1340
Mailing Address - Country:US
Mailing Address - Phone:203-530-2108
Mailing Address - Fax:
Practice Address - Street 1:421 HOPE ST
Practice Address - Street 2:UNIT E
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06906-1340
Practice Address - Country:US
Practice Address - Phone:203-530-2108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-22
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002962225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist