Healthcare Provider Details

I. General information

NPI: 1689594459
Provider Name (Legal Business Name): MOLLY KATE CHRISTENSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12400 S HIWASSEE RD
OKLAHOMA CITY OK
73165-7681
US

IV. Provider business mailing address

2602 W TUCSON ST APT 1528
BROKEN ARROW OK
74011-3787
US

V. Phone/Fax

Practice location:
  • Phone: 405-833-1013
  • Fax:
Mailing address:
  • Phone: 469-406-7255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number792724
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: