Basic Information
| Provider Information | |||||||||
| NPI: | 1841737756 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | FEE | ||||||||
| FirstName: | CHRISTINA | ||||||||
| MiddleName: | FERN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3200 SHORE DR | ||||||||
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| City: | MARINETTE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 541434202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9204333500 | ||||||||
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| Practice Location | |||||||||
| Address1: | 152 SADDLESHOP ROAD | ||||||||
| Address2: | |||||||||
| City: | HILLTOP | ||||||||
| State: | WV | ||||||||
| PostalCode: | 25855 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3044692966 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/30/2017 | ||||||||
| LastUpdateDate: | 07/08/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/08/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 1998 | WV | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 225X00000X | 0119007133 | VA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.