Provider Demographics
NPI:1518316439
Name:LACAYO, CHRISTIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:
Last Name:LACAYO
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 1:5506 CHILLUM PL NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-6203
Mailing Address - Country:US
Mailing Address - Phone:202-277-1768
Mailing Address - Fax:
Practice Address - Street 1:5506 CHILLUM PL NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-6203
Practice Address - Country:US
Practice Address - Phone:202-277-1768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-10
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04857225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist