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Individual

MR. MAREK KUKULKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMFT

Contact information

Practice address
896 ASYLUM AVE, HARTFORD, CT 06105-1901
(860) 493-1841
Mailing address
34 WALTER DR, GRISWOLD, CT 06351-3539
(860) 376-5475

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
000790
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1467545251
CT
Enumeration date
01/31/2007
Last updated
02/25/2016
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