Provider Demographics
NPI:1548601149
Name:KULIGA, KERIANNE
Entity Type:Individual
Prefix:
First Name:KERIANNE
Middle Name:
Last Name:KULIGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 MAIN ST
Mailing Address - Street 2:SUITES 302-303
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-1566
Mailing Address - Country:US
Mailing Address - Phone:207-571-9923
Mailing Address - Fax:207-571-9927
Practice Address - Street 1:209 MAIN ST
Practice Address - Street 2:SUITES 302-303
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-1566
Practice Address - Country:US
Practice Address - Phone:207-571-9923
Practice Address - Fax:207-571-9927
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC142181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical