Individual
MRS. CHRISTINA M DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, MOT, OTR
Contact information
Practice address
4870 E JACKSON ST, MUNCIE, IN 47303-4432
(765) 254-9717
(765) 254-9739
Mailing address
1200 W WHITE RIVER BLVD, RCS PROVIDER ENROLLMENT, MUNCIE, IN 47303-4988
(877) 668-5621
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31004751A
IN
Other
Enumeration date
01/19/2009
Last updated
12/16/2019
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