Individual
EMILY ACEVEDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
624 NW 5TH ST, MOORE, OK 73160-3924
(405) 799-3379
Mailing address
1060 NW 2ND ST, MOORE, OK 73160-2158
(318) 918-9555
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
OK
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
720506820
—
LA
Enumeration date
11/06/2023
Last updated
07/27/2026
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