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General NPI Number Information
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NPI Number | 1598592370
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Entity Type | Individual
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Provider Name | Z'KIAH KUYKENDALL LAC
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Gender | Female
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Dates
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Enumeration Date | 09/17/2024
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 920 E. MEDICAL DRIVE
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City | MANILA
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State | AR
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Zip | 72442
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Country | US
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Telephone | 870-570-0358
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Fax | 870-570-0359
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Provider Business Mailing Address
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Address Line | P.O. BOX 717
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City | MANILA
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State | AR
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Zip | 72442
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Country | US
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Telephone | 870-570-0358
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Fax | 870-570-0359
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | A2503006
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License Number State | AR
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