Provider Demographics
NPI:1790861433
Name:SIMMONS, CHRISTA RAE (OT)
Entity Type:Individual
Prefix:MS
First Name:CHRISTA
Middle Name:RAE
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
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Mailing Address - Street 1:5555 N LAMAR BLVD
Mailing Address - Street 2:STE L 103
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78751-1073
Mailing Address - Country:US
Mailing Address - Phone:512-200-2332
Mailing Address - Fax:512-852-4557
Practice Address - Street 1:5555 N LAMAR BLVD
Practice Address - Street 2:STE L 103
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78751-1073
Practice Address - Country:US
Practice Address - Phone:512-200-2332
Practice Address - Fax:512-852-4557
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2013-01-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX106204225XP0200X, 225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics