| Acquainted Llc | |
|
4502 East 41st St Tulsa OK 74135 | |
| (918) 361-3627 | |
| Not Available |
| Full Name | Acquainted Llc |
|---|---|
| Speciality | Social Worker |
| Location | 4502 East 41st St, Tulsa, Oklahoma |
| Authorized Official Name and Position | Kristal R Malveaux (MANAGER) |
| Authorized Official Contact | 9183613627 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Acquainted Llc 3171 S 129th East Ave Suite A Pmb 2054 Tulsa OK 74134-3215 Ph: (918) 361-3627 | Acquainted Llc 4502 East 41st St Tulsa OK 74135 Ph: (918) 361-3627 |
| NPI Number | 1487360293 |
|---|---|
| Provider Enumeration Date | 01/25/2023 |
| Last Update Date | 01/25/2023 |
| Certification Date | 01/18/2023 |
| Medicare PECOS PAC ID | 8820462781 |
|---|---|
| Medicare Enrollment ID | O20230327002193 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487360293 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kristal Rose Malveaux |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396889929 PECOS PAC ID: 0648644500 Enrollment ID: I20230504001764 |
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