Provider Demographics
NPI:1639179336
Name:HAYES, KARRIE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:KARRIE
Middle Name:
Last Name:HAYES
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4157 S HARVARD AVE
Mailing Address - Street 2:SUITE 117
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-2631
Mailing Address - Country:US
Mailing Address - Phone:918-712-7868
Mailing Address - Fax:918-749-2901
Practice Address - Street 1:4157 S HARVARD AVE
Practice Address - Street 2:SUITE 117
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2631
Practice Address - Country:US
Practice Address - Phone:918-712-7868
Practice Address - Fax:918-749-2901
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOT345225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
4333090OtherAETNA NON HMO
3764283OtherAETNA HMO