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General NPI Number Information
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NPI Number | 1023869120
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Entity Type | Individual
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Provider Name | KRISTAL O'CONNOR RBT
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Gender | Female
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Dates
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Enumeration Date | 03/28/2024
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 600 LIBERTY LN
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City | EDMOND
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State | OK
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Zip | 73034-9432
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Country | US
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Telephone | 732-806-0091
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Fax |
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Provider Business Mailing Address
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Address Line | 311 BOULEVARD OF THE AMERICAS STE 304
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City | LAKEWOOD
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State | NJ
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Zip | 08701
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Country | US
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Telephone | 732-806-0091
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-24-336453
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License Number State | OK
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