Provider Demographics
NPI:1205103892
Name:THOMPSON, CHRISTINE ELECIA LYNCH (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:ELECIA LYNCH
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:CHRISTINE
Other - Middle Name:ELECIA
Other - Last Name:LYNCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:866 DEEPWOOD CT
Mailing Address - Street 2:
Mailing Address - City:BOILING SPRINGS
Mailing Address - State:SC
Mailing Address - Zip Code:29316-6181
Mailing Address - Country:US
Mailing Address - Phone:646-314-2244
Mailing Address - Fax:
Practice Address - Street 1:1 MARTHA FRANKS DR
Practice Address - Street 2:
Practice Address - City:LAURENS
Practice Address - State:SC
Practice Address - Zip Code:29360-1772
Practice Address - Country:US
Practice Address - Phone:864-984-4541
Practice Address - Fax:864-681-8291
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-26
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6368225X00000X
NY013308225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY013308OtherOCCUPATIONAL THERAPY LICENSE NUMBER