Provider Demographics
NPI:1285399022
Name:KUCHLING, ROSA
Entity type:Individual
Prefix:
First Name:ROSA
Middle Name:
Last Name:KUCHLING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 S KANNER HWY
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2106
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 N ASHLEY DRIVE
Practice Address - Street 2:STE 1900
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-3360
Practice Address - Country:US
Practice Address - Phone:813-573-5824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-21-191204106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician