Doctor Name: | KATHLEEN PUCHALSKI |
NPI Number: | 1316141088 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 4240 East 2080 Rd Fort Towson, OK - 74735 |
Business Phone Number: | 5808739431 |
Business Fax Number: | |
Mailing Address: | Po Box 167, SWINK |
State: | OK |
Postal Code: | 747610167 |
Phone Number: | 5808739431 |
Fax Number: | |
NPI Enumeration Date: | 06/14/2007 |
NPI Last Update Date: | 03/27/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |