Provider Demographics
NPI:1679202881
Name:SWEINBERG, CHRISTINE (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:SWEINBERG
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10634 407TH AVE
Mailing Address - Street 2:
Mailing Address - City:GENOA CITY
Mailing Address - State:WI
Mailing Address - Zip Code:53128-2307
Mailing Address - Country:US
Mailing Address - Phone:815-355-8474
Mailing Address - Fax:
Practice Address - Street 1:517 E DIVISION ST
Practice Address - Street 2:
Practice Address - City:FOND DU LAC
Practice Address - State:WI
Practice Address - Zip Code:54935-3735
Practice Address - Country:US
Practice Address - Phone:920-921-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7233-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist