Provider Demographics
NPI:1174700322
Name:ARAGON, CHRISTINE LYBB (OTR)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:LYBB
Last Name:ARAGON
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 1:4609 GRAPE RD
Mailing Address - Street 2:SUITE B7
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46545-2649
Mailing Address - Country:US
Mailing Address - Phone:269-268-5601
Mailing Address - Fax:888-370-2324
Practice Address - Street 1:4609 GRAPE RD
Practice Address - Street 2:SUITE B7
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-2649
Practice Address - Country:US
Practice Address - Phone:269-268-5601
Practice Address - Fax:888-370-2324
Is Sole Proprietor?:No
Enumeration Date:2008-01-29
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201006523225X00000X
IN31001712A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist