Provider Demographics
NPI:1609153469
Name:MOKE, KRISTEN KALEEN (MA OTR/L)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:KALEEN
Last Name:MOKE
Suffix:
Gender:F
Credentials:MA OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:2301 COLUMBIA PIKE APT 125
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-4453
Mailing Address - Country:US
Mailing Address - Phone:571-527-0818
Mailing Address - Fax:202-379-1797
Practice Address - Street 1:405 8TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-5227
Practice Address - Country:US
Practice Address - Phone:202-544-5439
Practice Address - Fax:202-379-1797
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-08
Last Update Date:2019-07-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
0119006139225X00000X
DCOT010001277225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist