Provider Demographics
NPI:1437797982
Name:SMITH, CHRISTINE LOUISE (OTR/L)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:LOUISE
Last Name:SMITH
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:CHRISTINE
Other - Middle Name:LOUISE
Other - Last Name:MULLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:70 KINDERKAMACK RD STE 193
Mailing Address - Street 2:
Mailing Address - City:EMERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07630-1812
Mailing Address - Country:US
Mailing Address - Phone:201-267-6267
Mailing Address - Fax:201-267-0212
Practice Address - Street 1:70 KINDERKAMACK RD STE 103
Practice Address - Street 2:
Practice Address - City:EMERSON
Practice Address - State:NJ
Practice Address - Zip Code:07630-1812
Practice Address - Country:US
Practice Address - Phone:201-267-6267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-16
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00043300225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist