Provider Demographics
NPI:1811685886
Name:MILES, CHRISTINE ZUBA (OTR)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ZUBA
Last Name:MILES
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:NOELLE
Other - Last Name:ZUBA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:951 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:TYRONE
Mailing Address - State:PA
Mailing Address - Zip Code:16686-1426
Mailing Address - Country:US
Mailing Address - Phone:814-684-0320
Mailing Address - Fax:
Practice Address - Street 1:951 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:TYRONE
Practice Address - State:PA
Practice Address - Zip Code:16686-1426
Practice Address - Country:US
Practice Address - Phone:814-684-0388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC001564L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist