Provider Demographics
NPI:1275769044
Name:ROSSICS, CHRISTINA D (OTR/L)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:D
Last Name:ROSSICS
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 1:105 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:PACIFIC
Mailing Address - State:MO
Mailing Address - Zip Code:63069-1328
Mailing Address - Country:US
Mailing Address - Phone:636-257-4222
Mailing Address - Fax:
Practice Address - Street 1:105 S 6TH ST
Practice Address - Street 2:
Practice Address - City:PACIFIC
Practice Address - State:MO
Practice Address - Zip Code:63069-1328
Practice Address - Country:US
Practice Address - Phone:636-257-4222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-06
Last Update Date:2009-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO005048225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist