Kenna Joan Ault, MOT, OTR
Individual provider Active NPI Occupational Therapist · Grove, OK
NPI 1700930203 · NPPES record last updated Jun 9, 2008
Key facts
- NPI
- 1700930203
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 00375 (MO)
- Practice address
- 63095 E 293 Rd
Grove, OK 74344-6013 - Phone
- (918) 787-6564
- NPI assigned
- Jan 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00375 | MO | MD | Clinical Psychologist |
| 857 | OK | MD | Marriage & Family Therapist |
| 17-0119 | KS | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 00375 | MO | Yes |
| Occupational Therapist | 225X00000X | 17-0119 | KS | |
| Occupational Therapist | 225X00000X | 857 | OK |
Addresses
Primary practice location
63095 E 293 Rd
Grove, OK 74344-6013
Mailing address
63095 E 293 Rd
Grove, OK 74344-6013
Phone (918) 787-6564
Other names
- Kenna Joan Kinkade
Other providers in Grove, OK
- Anesthesia Associates of Grand Lake
- Ankle & Foot Centers of Mid-America
- Apollo Services Inc
- Amber Arnold
- Arrow Educational Consulting, LLC
- Lisa Meshelle Autry
- Aviation Medicine of Oklahoma
- Danielle Cherish Ballou-Allsup
- Ban NH, LLC
- Baptist Healthcare of Oklahoma
All providers in Grove, OK · Occupational Therapist in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 9, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.