Provider Demographics
NPI:1841737756
Name:FEE, CHRISTINA FERN
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:FERN
Last Name:FEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 SHORE DR
Mailing Address - Street 2:
Mailing Address - City:MARINETTE
Mailing Address - State:WI
Mailing Address - Zip Code:54143-4202
Mailing Address - Country:US
Mailing Address - Phone:920-433-3500
Mailing Address - Fax:
Practice Address - Street 1:152 SADDLESHOP ROAD
Practice Address - Street 2:
Practice Address - City:HILLTOP
Practice Address - State:WV
Practice Address - Zip Code:25855
Practice Address - Country:US
Practice Address - Phone:304-469-2966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-30
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1998225X00000X
VA0119007133225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist