Healthcare Provider Details

I. General information

NPI: 1053782847
Provider Name (Legal Business Name): KATHLEN KUHL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2015
Last Update Date: 10/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7801 ACADEMY RD NE STE 2-200
ALBUQUERQUE NM
87109-3380
US

IV. Provider business mailing address

7801 ACADEMY RD NE STE 2-200
ALBUQUERQUE NM
87109-3380
US

V. Phone/Fax

Practice location:
  • Phone: 505-273-6300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberM-08653
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: