Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT753 | OK |
NPI | 1003847252 |
---|---|
Provider Name | Mrs. Stephanie L Kuykendall |
First Address | Claremore, OK 74018-2206 |
Second Address | Claremore, OK 74017 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 27/07/2007 |