Individual
CHRISTINE CATHERINE KUKLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC-S, LSW
Contact information
Practice address
3280 WOODMAN DRIVE, KETTERING, OH 45420
(937) 474-4054
Mailing address
519 MONTGOMERY ST, MIAMISBURG, OH 45342-2955
(937) 474-4054
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
E.0002526-SUPV
OH
101YM0800X
Mental Health Counselor
Primary
E.0002526-SUPV
OH
Other
Enumeration date
08/24/2017
Last updated
07/21/2022
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