Provider Demographics
NPI:1609202464
Name:KUHL, HEATHER NICOLLE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:NICOLLE
Last Name:KUHL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7051 W COMMERCIAL BLVD
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33319-2146
Mailing Address - Country:US
Mailing Address - Phone:954-720-0412
Mailing Address - Fax:954-720-0824
Practice Address - Street 1:7051 W COMMERCIAL BLVD
Practice Address - Street 2:SUITE 3A
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-2146
Practice Address - Country:US
Practice Address - Phone:954-720-0412
Practice Address - Fax:954-720-0824
Is Sole Proprietor?:No
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8867103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical