Individual
MS. CHRISTINA A VANDEZANDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
2822 VENTURE DRIVE, MARQUETTE, MI 49855-8855
(906) 228-1863
(906) 225-0460
Mailing address
2822 VENTURE DRIVE, MARQUETTE, MI 49855-8855
(906) 228-1863
(906) 225-0460
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
225XG0600X
Gerontology Occupational Therapist
—
—
225XL0004X
Low Vision Occupational Therapist
—
—
225XM0800X
Mental Health Occupational Therapist
—
—
225XN1300X
Neurorehabilitation Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5201001027
LICENSE FOR OCCUPATIONAL THERAPY
MI
Enumeration date
04/17/2009
Last updated
11/03/2016
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