Healthcare Provider Details

I. General information

NPI: 1235085705
Provider Name (Legal Business Name): KYM ROBERTS-HARDESTY C. AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2026
Last Update Date: 03/07/2026
Certification Date: 03/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 WATER TOWER RD
SAND SPRINGS OK
74063-6320
US

IV. Provider business mailing address

32 N WATER ST
SAPULPA OK
74066-2816
US

V. Phone/Fax

Practice location:
  • Phone: 918-245-0406
  • Fax:
Mailing address:
  • Phone: 918-245-0406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number7364
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number7364
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: