Provider Demographics
NPI:1255096780
Name:MCDONALD, CHRISTINE LEE (OTA)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:LEE
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3878 GRANTS LN
Mailing Address - Street 2:
Mailing Address - City:IRONDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35210-5510
Mailing Address - Country:US
Mailing Address - Phone:318-658-7298
Mailing Address - Fax:
Practice Address - Street 1:235 INVERNESS CENTER DR
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35242-4805
Practice Address - Country:US
Practice Address - Phone:205-443-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-31
Last Update Date:2021-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3864224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant