Provider Demographics
NPI:1164455648
Name:YEARGAIN, KRISTY MICHELLE (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:KRISTY
Middle Name:MICHELLE
Last Name:YEARGAIN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 N PEBBLE CREEK TER APT 203
Mailing Address - Street 2:
Mailing Address - City:MUSTANG
Mailing Address - State:OK
Mailing Address - Zip Code:73064-4183
Mailing Address - Country:US
Mailing Address - Phone:405-376-1037
Mailing Address - Fax:
Practice Address - Street 1:2904 PARKLAWN DR
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-4204
Practice Address - Country:US
Practice Address - Phone:405-732-8900
Practice Address - Fax:405-732-1771
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1460225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist