Provider Demographics
NPI:1497801286
Name:ANSPACH, KIRSTEN BARBARA (OTR/L)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:BARBARA
Last Name:ANSPACH
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 1:720 LAGOON DR
Mailing Address - Street 2:
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-0000
Mailing Address - Country:US
Mailing Address - Phone:561-775-2533
Mailing Address - Fax:
Practice Address - Street 1:2532 W INDIANTOWN RD
Practice Address - Street 2:SUITE 2
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-3935
Practice Address - Country:US
Practice Address - Phone:561-748-5430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT11078225XP0200X
225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL888853100Medicaid