Provider Demographics
NPI:1316311871
Name:KULBERG, NADINE
Entity type:Individual
Prefix:
First Name:NADINE
Middle Name:
Last Name:KULBERG
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 1:65-1279 KAWAIHAE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-8444
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:65-1279 KAWAIHAE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743-8444
Practice Address - Country:US
Practice Address - Phone:808-887-0747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-20
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst