Healthcare Provider Details

I. General information

NPI: 1609380492
Provider Name (Legal Business Name): CHRISTINA CIOLEK OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2017
Last Update Date: 06/21/2021
Certification Date: 06/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 LEXINGTON RD
RICHMOND KY
40475-7924
US

IV. Provider business mailing address

432 WINDEMERE WAY
RICHMOND KY
40475-8260
US

V. Phone/Fax

Practice location:
  • Phone: 859-333-8147
  • Fax:
Mailing address:
  • Phone: 859-408-1004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5847
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number175449
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: