Provider Demographics
NPI:1699155499
Name:RYDER, CHRISTIANA FAITH (OTR/L)
Entity type:Individual
Prefix:MS
First Name:CHRISTIANA
Middle Name:FAITH
Last Name:RYDER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12110 BUSINESS BLVD
Mailing Address - Street 2:STE 6 PMB 413
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-7741
Mailing Address - Country:US
Mailing Address - Phone:907-317-7784
Mailing Address - Fax:
Practice Address - Street 1:12110 BUSINESS BLVD
Practice Address - Street 2:STE 6 PMB 413
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-7741
Practice Address - Country:US
Practice Address - Phone:907-317-7784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-05
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK100091225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist