Provider Demographics
NPI:1134012958
Name:PERFORS, KELSIE-LYNN KIMBERLY
Entity type:Individual
Prefix:
First Name:KELSIE-LYNN
Middle Name:KIMBERLY
Last Name:PERFORS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KELSIE-LYNN
Other - Middle Name:
Other - Last Name:KRAWIEC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7516 S 92ND EAST AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-5262
Mailing Address - Country:US
Mailing Address - Phone:719-322-5030
Mailing Address - Fax:
Practice Address - Street 1:11982 S MULBERRY CT
Practice Address - Street 2:
Practice Address - City:JENKS
Practice Address - State:OK
Practice Address - Zip Code:74037-2181
Practice Address - Country:US
Practice Address - Phone:918-201-1865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician