Provider Demographics
NPI:1255668232
Name:KUKRAL, VICKY (LMHC)
Entity Type:Individual
Prefix:
First Name:VICKY
Middle Name:
Last Name:KUKRAL
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 16TH ST SW
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:IA
Mailing Address - Zip Code:50677-2822
Mailing Address - Country:US
Mailing Address - Phone:319-352-2630
Mailing Address - Fax:319-352-0773
Practice Address - Street 1:106 16TH ST SW
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:IA
Practice Address - Zip Code:50677-2822
Practice Address - Country:US
Practice Address - Phone:319-352-2630
Practice Address - Fax:319-352-0773
Is Sole Proprietor?:No
Enumeration Date:2009-11-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health