Provider Demographics
NPI:1881730463
Name:HEGARTY, CHRISTINE MARIE (MS, OTR/L)
Entity type:Individual
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First Name:CHRISTINE
Middle Name:MARIE
Last Name:HEGARTY
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:204 E HANNA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33604-6719
Mailing Address - Country:US
Mailing Address - Phone:813-523-9392
Mailing Address - Fax:813-234-1314
Practice Address - Street 1:885 S PARSONS AVE
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-6063
Practice Address - Country:US
Practice Address - Phone:813-436-5900
Practice Address - Fax:813-436-5901
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOT12228225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics