Healthcare Provider Details

I. General information

NPI: 1982279600
Provider Name (Legal Business Name): KRISTI LEIGH PATOVISTI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KRISTI LEIGH MORGAN

II. Dates (important events)

Enumeration Date: 05/25/2021
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7012 E 117TH ST S
BIXBY OK
74008-8213
US

IV. Provider business mailing address

7012 E 117TH ST S
BIXBY OK
74008-8213
US

V. Phone/Fax

Practice location:
  • Phone: 918-361-6854
  • Fax:
Mailing address:
  • Phone: 918-361-6854
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number11926
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: