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General NPI Number Information
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NPI Number | 1255478301
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Entity Type | Individual
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Provider Name | TAMI JOAN KULKA
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Gender | Female
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 10/24/2014
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Provider Practice Location Address
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Address Line | 343 N. CARLISLE AVE.
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City | SOMERTON
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State | AZ
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Zip | 85350
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Country | US
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Telephone | 928-341-6041
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Fax | 928-341-6099
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Provider Business Mailing Address
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Address Line | 10340 S TYPHOON AVE
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City | YUMA
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State | AZ
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Zip | 85365-5700
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Country | US
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Telephone | 928-304-5179
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Fax | 928-341-6099
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State | AZ
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