Provider Demographics
NPI:1790487239
Name:REITZ, CHRISTINE (OTR/L)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:REITZ
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3159 CLUB DR
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32550-7807
Mailing Address - Country:US
Mailing Address - Phone:314-440-4263
Mailing Address - Fax:
Practice Address - Street 1:179 MACK BAYOU LOOP STE 302
Practice Address - Street 2:
Practice Address - City:SANTA ROSA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32459-7210
Practice Address - Country:US
Practice Address - Phone:850-278-3398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022031784225X00000X
IL56.015347225X00000X
FL25195225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist