=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275458259
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHRISTINE NICOLE DENNISON OTR/L, OTD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/11/2026
-----------------------------------------------------
Last Update Date | 08/11/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1601 NW 114TH ST STE 347
-----------------------------------------------------
City | CLIVE
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50325-7046
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 515-222-7350
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2241 HEARTHSTONE CIR SW
-----------------------------------------------------
City | ALTOONA
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50009-1683
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 320-552-2161
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | 140440
-----------------------------------------------------
License Number State | IA
-----------------------------------------------------