Healthcare Provider Details

I. General information

NPI: 1669701462
Provider Name (Legal Business Name): CHRISTOPHER THOMAS KUHL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2009
Last Update Date: 11/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1707 MAIN ST
LA CROSSE WI
54601-4200
US

IV. Provider business mailing address

1707 MAIN ST
LA CROSSE WI
54601-4200
US

V. Phone/Fax

Practice location:
  • Phone: 608-386-8390
  • Fax:
Mailing address:
  • Phone: 608-386-8390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1947-226
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: