Provider Demographics
NPI:1619634276
Name:KULIKOWSKI, EMILY MORGAN
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:MORGAN
Last Name:KULIKOWSKI
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 1:11107 PALLADIUM WAY
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-2517
Mailing Address - Country:US
Mailing Address - Phone:203-308-3292
Mailing Address - Fax:
Practice Address - Street 1:11107 PALLADIUM WAY
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-2517
Practice Address - Country:US
Practice Address - Phone:203-308-3292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician