Provider Demographics
NPI:1730813049
Name:MCQUINN, CHRISTINA (OTR/L)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:MCQUINN
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 1:10916 BACK RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-0182
Mailing Address - Country:US
Mailing Address - Phone:256-651-3575
Mailing Address - Fax:
Practice Address - Street 1:211 W MATTHEWS ST STE 203
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-1310
Practice Address - Country:US
Practice Address - Phone:704-846-0262
Practice Address - Fax:704-846-2958
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12943225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
339816OtherNBCOT
NC12943OtherOT STATE LICENSE