Provider Demographics
NPI:1285888263
Name:KINSLOW, CHRISTINA M (COTA/L)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:M
Last Name:KINSLOW
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 COURT ST
Mailing Address - Street 2:
Mailing Address - City:SUNBURY
Mailing Address - State:PA
Mailing Address - Zip Code:17801-2818
Mailing Address - Country:US
Mailing Address - Phone:570-286-7121
Mailing Address - Fax:
Practice Address - Street 1:800 COURT ST
Practice Address - Street 2:
Practice Address - City:SUNBURY
Practice Address - State:PA
Practice Address - Zip Code:17801-2818
Practice Address - Country:US
Practice Address - Phone:570-286-7121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-04
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP-003336-L305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service