Provider Demographics
NPI:1952379299
Name:DAVIES, CHRISTINA SUSANNA (OTR)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:SUSANNA
Last Name:DAVIES
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7875 ROBIN MEADOWS
Mailing Address - Street 2:
Mailing Address - City:FREELAND
Mailing Address - State:MI
Mailing Address - Zip Code:48623
Mailing Address - Country:US
Mailing Address - Phone:989-695-6542
Mailing Address - Fax:
Practice Address - Street 1:1607 MARQUETTE
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706
Practice Address - Country:US
Practice Address - Phone:989-684-0133
Practice Address - Fax:989-684-4098
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201003827225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist