Christina Ann Brubaker, COTA

Individual provider Active NPI Occupational Therapy Assistant · Alice, TX

NPI 1255810784 · NPPES record last updated Aug 7, 2018

Key facts

NPI
1255810784
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
209331 (TX)
Practice address
400 E Main St
Alice, TX 78332-4969
Phone
(361) 396-4029
NPI assigned
Aug 7, 2018
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
209331TXMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Little Lighthouse Childrens Rehab Past Accepting new patients
Little Lighthouse Childrens Rehab Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 209331 TX Yes

Addresses

Primary practice location

400 E Main St
Alice, TX 78332-4969

Mailing address

1501 Sunset Dr
Alice, TX 78332-4124

Other names

  • Christina Ann Goldate Other name

Other providers in Alice, TX

All providers in Alice, TX · Occupational Therapy Assistant in Texas

Sources for this page

Verify at the official NPI Registry.