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General NPI Number Information
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NPI Number | 1316760408
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Entity Type | Individual
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Provider Name | KATHLEEN GRACE KULP CLS
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Gender | Female
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Dates
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Enumeration Date | 11/06/2024
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 1332 LONDONTOWN BLVD STE 108D
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City | SYKESVILLE
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State | MD
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Zip | 21784-6587
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Country | US
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Telephone | 443-454-4404
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Fax |
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Provider Business Mailing Address
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Address Line | 5912 HANNA RD
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City | SYKESVILLE
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State | MD
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Zip | 21784-6717
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Country | US
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Telephone | 410-259-1707
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Fax |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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