Marjorie Ann Bagwell Kukor, PhD
Psychologist, Clinical in Springfield, OH. Individual provider (NPI-1).
NPI number1104009166
StatusActive
Last updated in NPPESSep 8, 2009
Details
- NPI
- 1104009166
- Entity type
- Individual (NPI-1)
- Name
- Marjorie Ann Bagwell Kukor
- Credential
- PhD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 13, 2007
- Last updated
- Sep 8, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 6340 | OH | Yes |
| 103T00000X | Psychologist | 6340 | OH | |
| 103T00000X | Psychologist | PPY01684 | MO |
Other names
- Marjorie Bagwell Kukor (Other Name)
Practice location
1130 Vester AveSuite C
Springfield, OH 45503-7302
Phone 937-390-3800 · Fax 937-390-3804
Mailing address
1130 Vester AveSuite C
Springfield, OH 45503-7302
Phone 937-390-3800 · Fax 937-390-3804
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