Provider Demographics
NPI:1902952997
Name:ACERS, KULWADEE 'LEE' (MS)
Entity type:Individual
Prefix:MS
First Name:KULWADEE 'LEE'
Middle Name:
Last Name:ACERS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 NW 21ST ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73103-1810
Mailing Address - Country:US
Mailing Address - Phone:405-528-7721
Mailing Address - Fax:405-528-7731
Practice Address - Street 1:616 NW 21ST ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73103-1810
Practice Address - Country:US
Practice Address - Phone:405-528-7721
Practice Address - Fax:405-528-7731
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3245101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK73 0636561OtherEIN