Provider Demographics
NPI:1982816997
Name:HOLMES, CHRISTINE (OT/L)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:
Last Name:HOLMES
Suffix:
Gender:F
Credentials:OT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 N.W. 13 ST
Mailing Address - Street 2:APT 33
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-2438
Mailing Address - Country:US
Mailing Address - Phone:561-706-1786
Mailing Address - Fax:
Practice Address - Street 1:4300 W CYPRESS ST
Practice Address - Street 2:SUITE 401
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-4145
Practice Address - Country:US
Practice Address - Phone:866-990-8880
Practice Address - Fax:866-990-8848
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5530225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist