Provider Demographics
NPI:1508971300
Name:KUNKEL, ALLISON LYNN (MS APSW)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:LYNN
Last Name:KUNKEL
Suffix:
Gender:F
Credentials:MS APSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20361 COUNTY HWY S
Mailing Address - Street 2:
Mailing Address - City:JIM FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54748-1824
Mailing Address - Country:US
Mailing Address - Phone:715-382-4710
Mailing Address - Fax:
Practice Address - Street 1:2004 HIGHLAND AVE
Practice Address - Street 2:SUITE N
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-4400
Practice Address - Country:US
Practice Address - Phone:715-835-5915
Practice Address - Fax:715-835-8112
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1071-121104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43578900Medicaid