Doctor Name: | MR. KENNETH R. KUKLA |
NPI Number: | 1881820348 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MS, CCC-SLP |
License Number: | 2049-154 |
Business Practice Address: | 638 N Broad St Elkhorn, WI - 531211104 |
Business Phone Number: | 2627235804 |
Business Fax Number: | 2627235874 |
Mailing Address: | 638 N Broad St, ELKHORN |
State: | WI |
Postal Code: | 531211104 |
Phone Number: | 2627235804 |
Fax Number: | 2627235874 |
NPI Enumeration Date: | 06/10/2009 |
NPI Last Update Date: | 06/10/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2049-154 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |