Healthcare Provider Details

I. General information

NPI: 1194808352
Provider Name (Legal Business Name): LAUREN P KOTULKA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 ROCK HILL RD
QUAKERTOWN PA
18951-4929
US

IV. Provider business mailing address

818 ROCK HILL RD
QUAKERTOWN PA
18951-4929
US

V. Phone/Fax

Practice location:
  • Phone: 215-622-7940
  • Fax:
Mailing address:
  • Phone: 215-622-7940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC008895
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: