Healthcare Provider Details

I. General information

NPI: 1104386168
Provider Name (Legal Business Name): STEPHANIE KUHLMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2019
Last Update Date: 03/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 E SILVER SPRINGS BLVD STE 134
OCALA FL
34470-6830
US

IV. Provider business mailing address

2928 NE 14TH AVE
OCALA FL
34479-3308
US

V. Phone/Fax

Practice location:
  • Phone: 352-355-2888
  • Fax:
Mailing address:
  • Phone: 616-302-3388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH17327
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: