Provider Demographics
NPI:1497910756
Name:MORAN, CHRISTY LYN (OTR/L)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:LYN
Last Name:MORAN
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 1:1600 7TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-1711
Mailing Address - Country:US
Mailing Address - Phone:205-638-5003
Mailing Address - Fax:205-638-6067
Practice Address - Street 1:1600 7TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1711
Practice Address - Country:US
Practice Address - Phone:205-939-6820
Practice Address - Fax:205-939-6063
Is Sole Proprietor?:No
Enumeration Date:2008-07-25
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0494225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL0494OtherALABAMA OCCUPATIONAL THERAPY LICENSE
980965OtherNATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY