Basic Information
| Provider Information | |||||||||
| NPI: | 1770734600 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KULHANEK | ||||||||
| FirstName: | JOY | ||||||||
| MiddleName: | L. | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 861 | ||||||||
| Address2: | |||||||||
| City: | ELMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 985410861 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604824083 | ||||||||
| FaxNumber: | 3604824083 | ||||||||
| Practice Location | |||||||||
| Address1: | 153 JOHNS CT | ||||||||
| Address2: | |||||||||
| City: | SHELTON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 985848225 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604272575 | ||||||||
| FaxNumber: | 3604272563 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/09/2008 | ||||||||
| LastUpdateDate: | 10/09/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | LL 00002878 | WA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.