Provider Demographics
NPI:1346882586
Name:CHRISTENSEN, INGEMERETE (OTA)
Entity Type:Individual
Prefix:
First Name:INGEMERETE
Middle Name:
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:INGEMERETE
Other - Middle Name:
Other - Last Name:MINSK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTA
Mailing Address - Street 1:22202 ESTATE HILL DR APT 3110
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3561
Mailing Address - Country:US
Mailing Address - Phone:210-538-8068
Mailing Address - Fax:
Practice Address - Street 1:5034 NEWFOREST DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-5459
Practice Address - Country:US
Practice Address - Phone:210-787-1729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-09
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX210809224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant