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General NPI Number Information
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NPI Number | 1558938043
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Entity Type | Individual
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Provider Name | MILA KIRSTIE CLARIN KULSA PH.D.
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Gender | Female
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Dates
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Enumeration Date | 06/04/2021
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Last Update Date | 10/25/2024
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Provider Practice Location Address
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Address Line | 1 PARK AVE FL 8
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City | NEW YORK
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State | NY
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Zip | 10016-5802
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Country | US
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Telephone | 212-263-7419
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Fax | 212-263-7460
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Provider Business Mailing Address
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Address Line | 23 REITER AVE
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City | HICKSVILLE
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State | NY
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Zip | 11801-5235
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Country | US
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Telephone | 516-456-6437
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 68-P132186-01
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License Number State | NY
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