Provider Demographics
NPI:1790066991
Name:DAWSON, CHRISTINE ANNA (COTA/L)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:ANNA
Last Name:DAWSON
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MRS
Other - First Name:CHRISTINE
Other - Middle Name:ANNA
Other - Last Name:SPRINGMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:91 CRESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:HARPERS FERRY
Mailing Address - State:WV
Mailing Address - Zip Code:25425
Mailing Address - Country:US
Mailing Address - Phone:304-433-2888
Mailing Address - Fax:
Practice Address - Street 1:6012 JEFFERSON BLVD
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-6953
Practice Address - Country:US
Practice Address - Phone:301-371-7160
Practice Address - Fax:301-371-5921
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-31
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00717224Z00000X
WVC1304224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant