Provider Demographics
NPI:1326318916
Name:GARRETT, KRISTIE DIONE
Entity Type:Individual
Prefix:MS
First Name:KRISTIE
Middle Name:DIONE
Last Name:GARRETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 SW 151ST ST
Mailing Address - Street 2:UNIT A
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-7582
Mailing Address - Country:US
Mailing Address - Phone:405-633-7143
Mailing Address - Fax:405-793-9993
Practice Address - Street 1:817 SW 151ST STREET
Practice Address - Street 2:UNIT A
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170-7582
Practice Address - Country:US
Practice Address - Phone:405-633-7143
Practice Address - Fax:405-793-9993
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst