MEDICARE: MS. CHRISTINA PHILLIP MS, OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	019572	NY
2	225X00000X	Occupational Therapist	0119007722	VA

General Provider Information

NPI Number	:	1144614405
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHRISTINA PHILLIP MS, OTR/L

Provider Business Mailing Address
First Line	:	3025 NOBLE AVE
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23222-2525
Country	:	US
Telephone Number	:	646-251-9562
Fax Number	:

Provider Business Practice Location Address
First Line	:	3025 NOBLE AVE
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23222-2525
Country	:	US
Telephone Number	:	646-251-9562
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2015
Last Update Date	:	10/24/2024

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