Provider Demographics
NPI:1619316890
Name:ST. CLAIR, KRISTINA NAOMI (BFA ED, BHRS)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:NAOMI
Last Name:ST. CLAIR
Suffix:
Gender:F
Credentials:BFA ED, BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1131 NW 15TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73106-4455
Mailing Address - Country:US
Mailing Address - Phone:405-657-0519
Mailing Address - Fax:
Practice Address - Street 1:1131 NW 15TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73106-4455
Practice Address - Country:US
Practice Address - Phone:405-657-0519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-20
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst