Provider Demographics
NPI:1356159941
Name:FRIESEN, CHRISTINA JUNE
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:JUNE
Last Name:FRIESEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 CAMBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:19015-1719
Mailing Address - Country:US
Mailing Address - Phone:385-205-7972
Mailing Address - Fax:
Practice Address - Street 1:1695 LENAPE RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-6801
Practice Address - Country:US
Practice Address - Phone:610-344-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-28
Last Update Date:2024-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP010639224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant