Individual
EMMA RAE KUKULSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3160 STILLWATER DR, PRESCOTT, AZ 86305-7151
(928) 776-9285
Mailing address
3160 STILLWATER DR, PRESCOTT, AZ 86305-7151
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SLPA12851
AZ
Other
Enumeration date
01/11/2023
Last updated
01/11/2023
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