Provider Demographics
NPI:1427402437
Name:KIOUS, SHERRY (MOTR/L, CLT)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:KIOUS
Suffix:
Gender:F
Credentials:MOTR/L, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8412 N ASHLEY DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73025-1559
Mailing Address - Country:US
Mailing Address - Phone:405-833-7781
Mailing Address - Fax:
Practice Address - Street 1:4301 NW 63RD ST STE 304
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-1504
Practice Address - Country:US
Practice Address - Phone:405-858-8737
Practice Address - Fax:405-879-0247
Is Sole Proprietor?:No
Enumeration Date:2016-04-15
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1823225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist