Provider Demographics
NPI:1033414461
Name:SOWARDS, KRISTINA (OTR/L)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:SOWARDS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:
Other - Last Name:BRUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:4129 S TRENTON AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-4027
Mailing Address - Country:US
Mailing Address - Phone:918-361-9722
Mailing Address - Fax:
Practice Address - Street 1:4129 S TRENTON AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-4027
Practice Address - Country:US
Practice Address - Phone:918-361-9722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-15
Last Update Date:2011-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1307225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist