Healthcare Provider Details

I. General information

NPI: 1356517973
Provider Name (Legal Business Name): KRISTIN YIP OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2008
Last Update Date: 01/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2644 RIVA RD
ANNAPOLIS MD
21401-7427
US

IV. Provider business mailing address

3055 RIVERVIEW RD
RIVA MD
21140-1332
US

V. Phone/Fax

Practice location:
  • Phone: 917-968-1364
  • Fax:
Mailing address:
  • Phone: 917-968-1364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: