Provider Demographics
NPI:1225087851
Name:DUTCHESS, CHRISTI TODD (MS, OTR)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTI
Middle Name:TODD
Last Name:DUTCHESS
Suffix:
Gender:F
Credentials:MS, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1022 TEXAS AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-4340
Mailing Address - Country:US
Mailing Address - Phone:317-441-7286
Mailing Address - Fax:
Practice Address - Street 1:520 S FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801-5229
Practice Address - Country:US
Practice Address - Phone:800-378-7597
Practice Address - Fax:877-399-5578
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT19756225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200605380OtherIHCP MBR NUMBER