Provider Demographics
NPI:1134803430
Name:GULKIS, KARLEE ROSE (RBT)
Entity type:Individual
Prefix:
First Name:KARLEE
Middle Name:ROSE
Last Name:GULKIS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:35 LAUREL CT
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-5105
Mailing Address - Country:US
Mailing Address - Phone:516-423-3308
Mailing Address - Fax:
Practice Address - Street 1:6080 JERICHO TPKE STE 200
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-2808
Practice Address - Country:US
Practice Address - Phone:631-864-7770
Practice Address - Fax:631-864-7773
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-15
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RBT-23-276410106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician