Provider Demographics
NPI:1053723809
Name:KULHANEK, KAYLIN (MA CFY-SLP)
Entity type:Individual
Prefix:
First Name:KAYLIN
Middle Name:
Last Name:KULHANEK
Suffix:
Gender:F
Credentials:MA CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12945 CHARLSTON CT
Mailing Address - Street 2:
Mailing Address - City:ROSEMOUNT
Mailing Address - State:MN
Mailing Address - Zip Code:55068-5024
Mailing Address - Country:US
Mailing Address - Phone:651-587-9877
Mailing Address - Fax:
Practice Address - Street 1:8450 CITY CENTRE DR
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-5308
Practice Address - Country:US
Practice Address - Phone:612-210-8835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-28
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9275235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist