Provider Demographics
NPI:1699150151
Name:MAYKULSKY, VICKI
Entity type:Individual
Prefix:
First Name:VICKI
Middle Name:
Last Name:MAYKULSKY
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 1:2200 HARVARD RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-2611
Mailing Address - Country:US
Mailing Address - Phone:785-842-0656
Mailing Address - Fax:
Practice Address - Street 1:2200 HARVARD RD
Practice Address - Street 2:SUITE 101
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-2611
Practice Address - Country:US
Practice Address - Phone:785-842-0656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-27
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS710235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist