Individual
MITCHELL WADE KULAWIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.S., C.A.D.C
Contact information
Practice address
505 5TH ST STE 520, SIOUX CITY, IA 51101-1506
(402) 681-5000
(712) 277-2187
Mailing address
505 5TH ST STE 520, SIOUX CITY, IA 51101-1506
(402) 681-5000
(712) 277-2187
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1374
IA
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922407485
—
IA
Enumeration date
08/20/2014
Last updated
05/06/2020
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