Provider Demographics
NPI:1932656303
Name:WADE, KAULIN (M ED)
Entity Type:Individual
Prefix:MRS
First Name:KAULIN
Middle Name:
Last Name:WADE
Suffix:
Gender:F
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2109 WASHINGTON OVERLOOK DR
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-1449
Mailing Address - Country:US
Mailing Address - Phone:240-270-3154
Mailing Address - Fax:
Practice Address - Street 1:2109 WASHINGTON OVERLOOK DR
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-1449
Practice Address - Country:US
Practice Address - Phone:240-270-3154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-02
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health