Provider Demographics
NPI:1467813238
Name:GUIRL, KIMBERLY K (OTR/L)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:K
Last Name:GUIRL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:K
Other - Last Name:SCHOBORG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:5350 E 31ST ST STE 302
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-5008
Mailing Address - Country:US
Mailing Address - Phone:918-933-4085
Mailing Address - Fax:405-286-9828
Practice Address - Street 1:5350 E 31ST ST STE 302
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-5008
Practice Address - Country:US
Practice Address - Phone:918-933-4018
Practice Address - Fax:918-779-7794
Is Sole Proprietor?:No
Enumeration Date:2016-03-08
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225XL0004X
OK1604225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XL0004XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistLow Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200632370AMedicaid
OK478528YX5DMedicare PIN