Provider Demographics
NPI:1194926303
Name:KUNZ, COLLEEN MAY (ATR-BC)
Entity type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:MAY
Last Name:KUNZ
Suffix:
Gender:F
Credentials:ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:734 GRAVEL RD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-1716
Mailing Address - Country:US
Mailing Address - Phone:585-671-1078
Mailing Address - Fax:
Practice Address - Street 1:734 GRAVEL RD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-1716
Practice Address - Country:US
Practice Address - Phone:585-671-1078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000671-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health