Provider Demographics
NPI:1881913283
Name:MARTINI, KRISTINA L (OTR/L)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:L
Last Name:MARTINI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:L
Other - Last Name:ERICSON-BLASI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR/L
Mailing Address - Street 1:PO BOX 3568
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CT
Mailing Address - Zip Code:06525-0141
Mailing Address - Country:US
Mailing Address - Phone:203-387-1401
Mailing Address - Fax:203-387-1415
Practice Address - Street 1:15 RESEARCH DR
Practice Address - Street 2:UNIT 1
Practice Address - City:WOODBRIDGE
Practice Address - State:CT
Practice Address - Zip Code:06525-2348
Practice Address - Country:US
Practice Address - Phone:203-387-1401
Practice Address - Fax:203-387-1415
Is Sole Proprietor?:No
Enumeration Date:2010-05-25
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3000225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist