Individual
KIM M. CUCULI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.R.
Contact information
Practice address
800 GENEVA PKWY N STE 3, LAKE GENEVA, WI 53147
(262) 248-9902
(262) 248-9419
Mailing address
800 GENEVA PKWY N STE 3, LAKE GENEVA, WI 53147-5701
(262) 248-9902
(262) 249-9419
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1594
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01063884
RR MEDICARE
WI
Enumeration date
07/01/2006
Last updated
08/21/2018
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