Provider Demographics
NPI:1770734600
Name:KULHANEK, JOY L (SLP)
Entity type:Individual
Prefix:MRS
First Name:JOY
Middle Name:L
Last Name:KULHANEK
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 861
Mailing Address - Street 2:
Mailing Address - City:ELMA
Mailing Address - State:WA
Mailing Address - Zip Code:98541-0861
Mailing Address - Country:US
Mailing Address - Phone:360-482-4083
Mailing Address - Fax:360-482-4083
Practice Address - Street 1:153 JOHNS CT
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:WA
Practice Address - Zip Code:98584-8225
Practice Address - Country:US
Practice Address - Phone:360-427-2575
Practice Address - Fax:360-427-2563
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL 00002878235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist