Provider Demographics
NPI:1124286257
Name:BEEKSMA, CHRISTINA LYNN (COTA)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LYNN
Last Name:BEEKSMA
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 E NORTHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:IRONWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49938-1363
Mailing Address - Country:US
Mailing Address - Phone:906-932-4833
Mailing Address - Fax:
Practice Address - Street 1:203 E NORTHLAND AVE
Practice Address - Street 2:
Practice Address - City:IRONWOOD
Practice Address - State:MI
Practice Address - Zip Code:49938-1363
Practice Address - Country:US
Practice Address - Phone:906-932-4833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1753-027224Z00000X
MI5202226888224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant