Healthcare Provider Details

I. General information

NPI: 1093046922
Provider Name (Legal Business Name): CHRISTI DANIELLE MCKIM MS, OTR/L, ATP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2010
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11003 BLUEGRASS PKWY STE 460
LOUISVILLE KY
40299-2392
US

IV. Provider business mailing address

207 FRANCK AVE
LOUISVILLE KY
40206-2544
US

V. Phone/Fax

Practice location:
  • Phone: 502-266-5213
  • Fax: 800-809-5213
Mailing address:
  • Phone: 812-596-0116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code225CA2400X
TaxonomyAssistive Technology Practitioner Rehabilitation Counselor
License Number
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code225CA2400X
TaxonomyAssistive Technology Practitioner Rehabilitation Counselor
License Number
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code225CA2400X
TaxonomyAssistive Technology Practitioner Rehabilitation Counselor
License Number
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number31004237A
License Number StateIN
# 6
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number StateNULL
# 7
Primary TaxonomyN
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number164536
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: