Provider Demographics
NPI:1659496933
Name:ESPIRITU, CHRISTINE CLATA (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:CLATA
Last Name:ESPIRITU
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:CHRISTINE
Other - Middle Name:MANGALI
Other - Last Name:CLATA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTRP, OTR
Mailing Address - Street 1:9000 CHAPEL RD APT 10102
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-8744
Mailing Address - Country:US
Mailing Address - Phone:561-706-7940
Mailing Address - Fax:
Practice Address - Street 1:2320 LAKE SHORE DR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76708-1276
Practice Address - Country:US
Practice Address - Phone:254-752-1075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2015-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12688225X00000X
TX113091225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist