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General NPI Number Information
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NPI Number | 1487360293
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Entity Type | Organization
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Legal Business Name | ACQUAINTED LLC
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Dates
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Enumeration Date | 01/25/2023
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Last Update Date | 01/25/2023
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Provider Practice Location Address
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Address Line | 4502 EAST 41ST ST
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City | TULSA
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State | OK
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Zip | 74135
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Country | US
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Telephone | 918-361-3627
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Fax |
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Provider Business Mailing Address
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Address Line | 3171 S 129TH EAST AVE SUITE A PMB 2054
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City | TULSA
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State | OK
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Zip | 74134-3215
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Country | US
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Telephone | 918-361-3627
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | KRISTAL R MALVEAUX
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Credential | LCSW
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Telephone | 918-361-3627
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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