Provider Demographics
NPI:1295966190
Name:KULA, STEPHANIE M (MAC LAC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:M
Last Name:KULA
Suffix:
Gender:F
Credentials:MAC LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 COLONIAL ROAD #9
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970
Mailing Address - Country:US
Mailing Address - Phone:781-269-2287
Mailing Address - Fax:
Practice Address - Street 1:4 COMMUNITY RD
Practice Address - Street 2:7816318330
Practice Address - City:MARBLEHEAD
Practice Address - State:MA
Practice Address - Zip Code:01945-2766
Practice Address - Country:US
Practice Address - Phone:781-631-8330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-27
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist