Individual
KRISTIN J WIARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
711 N 5TH ST, JENKS, OK 74037-3343
(918) 299-8508
Mailing address
18617 E 46TH PL S, TULSA, OK 74134-5501
(918) 946-7100
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1304
OK
Other
Enumeration date
07/12/2022
Last updated
07/12/2022
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