Provider Demographics
NPI:1922387224
Name:CHRISTIANSEN, JILL (OTR)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:CHRISTIANSEN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WILTSHIRE CT
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-7677
Mailing Address - Country:US
Mailing Address - Phone:214-924-9213
Mailing Address - Fax:
Practice Address - Street 1:1 WILTSHIRE CT
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-7677
Practice Address - Country:US
Practice Address - Phone:214-924-9213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-04
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108019225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics