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Individual

RICHARD MARLIN KUNKLE

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
2500 SHOW LOW LAKE RD, SHOW LOW, AZ 85901-7929
(928) 537-2951
(928) 537-8520
Mailing address
2500 SHOW LOW LAKE RD, SHOW LOW, AZ 85901-7929
(928) 537-2951
(928) 537-8520

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW2818
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
734310
AHCCCS
AZ
Enumeration date
04/20/2006
Last updated
07/08/2007
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