Provider Demographics
NPI:1215329511
Name:KYULULE, JOEL
Entity type:Individual
Prefix:MR
First Name:JOEL
Middle Name:
Last Name:KYULULE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6605 N 93RD AVE
Mailing Address - Street 2:UNIT 1066
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85305-3115
Mailing Address - Country:US
Mailing Address - Phone:623-877-8206
Mailing Address - Fax:623-877-8992
Practice Address - Street 1:6605 N 93RD AVE
Practice Address - Street 2:UNIT 1066
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85305-3115
Practice Address - Country:US
Practice Address - Phone:623-877-8206
Practice Address - Fax:623-877-8992
Is Sole Proprietor?:No
Enumeration Date:2015-02-23
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor