Provider Demographics
NPI:1548597552
Name:BATE, KRISTINA D (OTR/L)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:D
Last Name:BATE
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 1:6205 WINDING LAKE DR
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-3789
Mailing Address - Country:US
Mailing Address - Phone:561-222-6581
Mailing Address - Fax:561-748-1241
Practice Address - Street 1:6205 WINDING LAKE DR
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-3789
Practice Address - Country:US
Practice Address - Phone:561-222-6581
Practice Address - Fax:561-748-1241
Is Sole Proprietor?:No
Enumeration Date:2009-11-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT6245225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist