Individual
MARY YVONNE KITCHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
133 W WINSTON ST, BROKEN ARROW, OK 74011-6843
(918) 504-5385
Mailing address
133 W WINSTON ST, BROKEN ARROW, OK 74011-6843
(918) 504-5385
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT519
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200210410A
—
OK
Enumeration date
04/19/2007
Last updated
07/27/2009
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