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NPI Code Detail

MEDICARE: CARLY KUCHAREK

MEDICARE: CARLY KUCHAREK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1871201442
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLY KUCHAREK
Provider Business Mailing Address
First Line : 3477 GULL RD
Second Line :
City : KALAMAZOO
State : MI
Zip : 49048-1281
Country : US
Telephone Number : 269-249-1490
Fax Number :
Provider Business Practice Location Address
First Line : 3744 GULL RD
Second Line :
City : KALAMAZOO
State : MI
Zip : 49048-7642
Country : US
Telephone Number : 269-249-1490
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2022
Last Update Date : 09/18/2025

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Directions to “ CARLY KUCHAREK ” Practice Location

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