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Individual

MR. DAVID A KUYKENDALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW CADC III CCS

Contact information

Practice address
1500 W MAIN ST, SUITE 300 PHOENIX COUNSELING, SUN PRAIRIE, WI 53590
(608) 825-6711
(608) 834-6499
Mailing address
N 5584 CTY HWY A, LAKE MILLS, WI 53551
(608) 825-6711
(608) 834-6499

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
645123
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
220
STATE OF WI
WI
05
39517000
WI
01
645123
STATE OF WI
WI
Enumeration date
10/25/2006
Last updated
07/08/2007
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