Individual
KATHLEEN PUCHALSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4240 EAST 2080 RD, FORT TOWSON, OK 74735
(580) 873-9431
Mailing address
PO BOX 167, SWINK, OK 74761-0167
(580) 873-9431
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
06/14/2007
Last updated
03/27/2012
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