Provider Demographics
NPI:1801086236
Name:CARSWELL, KRISTIANNA
Entity type:Individual
Prefix:
First Name:KRISTIANNA
Middle Name:
Last Name:CARSWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KRISTIANNA
Other - Middle Name:
Other - Last Name:BEDDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1030
Mailing Address - Street 2:
Mailing Address - City:ANTLERS
Mailing Address - State:OK
Mailing Address - Zip Code:74523-1030
Mailing Address - Country:US
Mailing Address - Phone:580-298-2830
Mailing Address - Fax:
Practice Address - Street 1:2816 E JACKSON ST
Practice Address - Street 2:
Practice Address - City:HUGO
Practice Address - State:OK
Practice Address - Zip Code:74743-4250
Practice Address - Country:US
Practice Address - Phone:580-326-5350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor