Healthcare Provider Details

I. General information

NPI: 1215845557
Provider Name (Legal Business Name): CHRISTINA BRANSCOMB
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 BLUE JACKET CIRCLE
PICKERINGTON OH
43147-8044
US

IV. Provider business mailing address

5694 LAPPERELL RD
BAINBRIDGE OH
45612-9618
US

V. Phone/Fax

Practice location:
  • Phone: 614-354-2809
  • Fax:
Mailing address:
  • Phone: 740-804-6087
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA0080066
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: