=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245391291
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KULIG & ASSOCIATES INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/13/2006
-----------------------------------------------------
Last Update Date | 09/03/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 900 S US HWY ONE SUITE 101
-----------------------------------------------------
City | JUPITER
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33477
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-743-6517
-----------------------------------------------------
Fax | 561-743-3329
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 900 S US HWY ONE SUITE 101
-----------------------------------------------------
City | JUPITER
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33477
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-743-6517
-----------------------------------------------------
Fax | 561-743-3329
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MARTHA A KULIG
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 561-743-6517
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number | SW3400
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------