Provider Demographics
NPI:1699216929
Name:LITTEER, KRISTEN LEEANN
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:LEEANN
Last Name:LITTEER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2404 W VICKSBURG ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74011-1531
Mailing Address - Country:US
Mailing Address - Phone:918-927-5294
Mailing Address - Fax:
Practice Address - Street 1:2404 W VICKSBURG ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74011-1531
Practice Address - Country:US
Practice Address - Phone:918-927-5294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-20
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician