Provider Demographics
NPI:1437429826
Name:EVES, KRISTA L (OTR/L)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:L
Last Name:EVES
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KRISTA
Other - Middle Name:L
Other - Last Name:MORGIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:8481 COUNTY ROUTE 9
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NY
Mailing Address - Zip Code:13624-3312
Mailing Address - Country:US
Mailing Address - Phone:315-686-5594
Mailing Address - Fax:
Practice Address - Street 1:8481 COUNTY ROUTE 9
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NY
Practice Address - Zip Code:13624-3312
Practice Address - Country:US
Practice Address - Phone:315-686-5594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-03
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007568-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist