Provider Demographics
NPI:1245460427
Name:SUSSHINE, CHRISTINA ANN (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:ANN
Last Name:SUSSHINE
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8481 SUNBRIGHT DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247-3488
Mailing Address - Country:US
Mailing Address - Phone:513-378-2336
Mailing Address - Fax:
Practice Address - Street 1:5343 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45224-3130
Practice Address - Country:US
Practice Address - Phone:513-853-2749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-22
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA-02689224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant