Provider Demographics
NPI:1851520373
Name:ROSS, CHRISTINA M (OT)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:M
Last Name:ROSS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:M
Other - Last Name:SUBERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:600 S BROAD ST
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-3346
Mailing Address - Country:US
Mailing Address - Phone:800-790-9946
Mailing Address - Fax:
Practice Address - Street 1:660 N BROAD ST
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-2361
Practice Address - Country:US
Practice Address - Phone:215-361-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC011061225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist