Provider Demographics
NPI:1184254377
Name:RECINTO, CHRISTINE ALISE (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ALISE
Last Name:RECINTO
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7016 RANCHO DE TAOS CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-1000
Mailing Address - Country:US
Mailing Address - Phone:702-445-3905
Mailing Address - Fax:
Practice Address - Street 1:7016 RANCHO DE TAOS CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-1000
Practice Address - Country:US
Practice Address - Phone:702-445-3905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-16
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVOT-2418225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist