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General NPI Number Information
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NPI Number | 1710308747
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Entity Type | Individual
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Provider Name | KRISTINE GILLETTE
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Gender | Female
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Dates
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Enumeration Date | 12/17/2013
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Last Update Date | 12/17/2013
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Provider Practice Location Address
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Address Line | 2725 10TH ST NE
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City | WASHINGTON
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State | DC
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Zip | 20018-1711
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Country | US
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Telephone | 202-281-2580
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Fax |
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Provider Business Mailing Address
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Address Line | 3726 CONNECTICUT AVE NW APT 508
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City | WASHINGTON
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State | DC
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Zip | 20008-4557
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT010000879
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License Number State | DC
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