Provider Demographics
NPI:1437496130
Name:FLOYD, CHRISTINA JOLENE (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:JOLENE
Last Name:FLOYD
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 554
Mailing Address - Street 2:
Mailing Address - City:MCCOMB
Mailing Address - State:MS
Mailing Address - Zip Code:39649-0554
Mailing Address - Country:US
Mailing Address - Phone:601-551-1160
Mailing Address - Fax:
Practice Address - Street 1:501 S LOCUST ST
Practice Address - Street 2:
Practice Address - City:MCCOMB
Practice Address - State:MS
Practice Address - Zip Code:39648-4336
Practice Address - Country:US
Practice Address - Phone:601-684-8111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSTA2619224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant