Provider Demographics
NPI:1417337544
Name:STRAUB, CHRISTINE (COTA)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:STRAUB
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:TICE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1685 OLD HIGHWAY 99 S
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-9771
Mailing Address - Country:US
Mailing Address - Phone:845-978-5632
Mailing Address - Fax:
Practice Address - Street 1:135 MAPLE ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1514
Practice Address - Country:US
Practice Address - Phone:845-978-5632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-03
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR334988224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant