Provider Demographics
NPI:1912000100
Name:SCHROYER-GREEN, CHRISTINE (OTR/L, CLT)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:
Last Name:SCHROYER-GREEN
Suffix:
Gender:F
Credentials:OTR/L, CLT
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L, CLT
Mailing Address - Street 1:5166 ROYAL PADDOCK WAY
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32953-7541
Mailing Address - Country:US
Mailing Address - Phone:772-380-3293
Mailing Address - Fax:
Practice Address - Street 1:5166 ROYAL PADDOCK WAY
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32953-7541
Practice Address - Country:US
Practice Address - Phone:772-380-3293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT12207225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL891346300Medicaid