MEDICARE: CHRISTINE A. HENSHAW OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	25146	FL

General Provider Information

NPI Number	:	1700627189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE A. HENSHAW OTR/L

Provider Business Mailing Address
First Line	:	11567 SW BEN DR
Second Line	:
City	:	LAKE SUZY
State	:	FL
Zip	:	34269-5985
Country	:	US
Telephone Number	:	609-513-7133
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 AQUI ESTA DR
Second Line	:
City	:	PUNTA GORDA
State	:	FL
Zip	:	33950-6534
Country	:	US
Telephone Number	:	609-513-7133
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2024
Last Update Date	:	06/07/2024

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