Provider Demographics
NPI:1922217207
Name:RULKA, KATHLEEN MICHELLE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:MICHELLE
Last Name:RULKA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:KATHLEEN
Other - Middle Name:MICHELLE
Other - Last Name:RULKA-HATHAWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:N. 7149 525TH STREET
Mailing Address - Street 2:
Mailing Address - City:MENOMONIE
Mailing Address - State:WI
Mailing Address - Zip Code:54751
Mailing Address - Country:US
Mailing Address - Phone:715-308-2452
Mailing Address - Fax:
Practice Address - Street 1:900 W CLAIREMONT AVE
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-6122
Practice Address - Country:US
Practice Address - Phone:715-271-2927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI698-124106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist