Healthcare Provider Details

I. General information

NPI: 1801470281
Provider Name (Legal Business Name): KAYLI RENEE ARNETT LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2021
Last Update Date: 01/13/2024
Certification Date: 01/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 S HARVARD AVE
TULSA OK
74112-5819
US

IV. Provider business mailing address

21132 E 480 RD
CLAREMORE OK
74019-3999
US

V. Phone/Fax

Practice location:
  • Phone: 918-373-4685
  • Fax:
Mailing address:
  • Phone: 918-373-4685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number186259
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: