Provider Demographics
NPI:1700342631
Name:COMBS, CHRISTINA (OTR/L)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:COMBS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:
Other - Last Name:BRENNOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:910 S WINTERHAWK DR UNIT 107
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-3870
Mailing Address - Country:US
Mailing Address - Phone:904-217-3914
Mailing Address - Fax:
Practice Address - Street 1:910 S WINTERHAWK DR UNIT 107
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-3870
Practice Address - Country:US
Practice Address - Phone:904-217-3914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-15
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA16876224Z00000X
FLOT25971225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOT25971OtherOCCUPATIONAL THERAPIST
FLOTA16876OtherOCCUPATIONAL THERAPY ASSISTANT