Provider Demographics
NPI:1255956850
Name:KULINA, MACKENZIE COREY
Entity type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:COREY
Last Name:KULINA
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 1:17633 W ASTER DR
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85388-5658
Mailing Address - Country:US
Mailing Address - Phone:623-466-5567
Mailing Address - Fax:
Practice Address - Street 1:2131 E BROADWAY RD
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-1737
Practice Address - Country:US
Practice Address - Phone:480-329-0881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-10
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor