Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 2750 | NC |
NPI | 1063606176 |
---|---|
Provider Name | Dr. Jeffrey C. Kulley |
First Address | Durham, NC 27705-5802 |
Second Address | Durham, NC 27705-4120 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2007 |
Last Update Date | 31/08/2007 |