Healthcare Provider Details

I. General information

NPI: 1134558620
Provider Name (Legal Business Name): MELISSA KUHL M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2013
Last Update Date: 11/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

732 BELL RUSSELL WAY
SACRAMENTO CA
95831-4241
US

IV. Provider business mailing address

732 BELL RUSSELL WAY
SACRAMENTO CA
95831-4241
US

V. Phone/Fax

Practice location:
  • Phone: 916-715-3162
  • Fax:
Mailing address:
  • Phone: 916-715-3162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberIMF 76359
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: