Kristin Shide, O.T.

NPI #1124249867 in South Bend, Indiana

Provider Information

NPI Number: 1124249867
Entity Type: Individual
Name: Kristin Shide, O.T.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Occupational Therapist
Credential: O.T.
Enumeration Date: May 1, 2007
Last Updated: Jul 9, 2007

Practice Location

Address: 2505 E JEFFERSON BLVD
City: South Bend
State: Indiana
ZIP Code: 46615-2635
Phone: (574) 289-4831

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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