Provider Demographics
NPI:1588102396
Name:STINES, CHRISTIN (COTA/L)
Entity type:Individual
Prefix:
First Name:CHRISTIN
Middle Name:
Last Name:STINES
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 1:386 RIVER BREEZE LN
Mailing Address - Street 2:
Mailing Address - City:ETOWAH
Mailing Address - State:NC
Mailing Address - Zip Code:28729-0049
Mailing Address - Country:US
Mailing Address - Phone:828-606-6615
Mailing Address - Fax:
Practice Address - Street 1:386 RIVER BREEZE LN
Practice Address - Street 2:
Practice Address - City:ETOWAH
Practice Address - State:NC
Practice Address - Zip Code:28729-0049
Practice Address - Country:US
Practice Address - Phone:828-606-6615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-01
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10708224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant