Provider Demographics
NPI:1265670681
Name:STIRLACCI, CHRISTINE CAROL (MS,OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:CAROL
Last Name:STIRLACCI
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 1:235 ATWATER RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01107-1254
Mailing Address - Country:US
Mailing Address - Phone:413-736-2169
Mailing Address - Fax:
Practice Address - Street 1:235 ATWATER RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1254
Practice Address - Country:US
Practice Address - Phone:413-736-2169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-22
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3456225X00000X
MA6751225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist