Individual
DEBRA J KULTGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
634 W HISTORIC MITCHELL ST, MILWAUKEE, WI 53204-3512
(414) 383-4486
Mailing address
N143W6269 PIONEER RD, CEDARBURG, WI 53012-2722
(414) 383-4486
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7106-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40929700
—
WI
Enumeration date
12/20/2006
Last updated
07/08/2007
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