Provider Demographics
NPI:1477125276
Name:DEL MUNDO, CHRISTINE (COTA)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:DEL MUNDO
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 ROCK SPRINGS DR APT 2136
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-3153
Mailing Address - Country:US
Mailing Address - Phone:773-931-7573
Mailing Address - Fax:
Practice Address - Street 1:2250 E FLAMINGO RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5170
Practice Address - Country:US
Practice Address - Phone:702-784-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVOTA-2181224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant