MEDICARE: MS. KATHARINE COFFIN HULSE M.ED., ITDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	NONE
2	222Q00000X	Developmental Therapist

General Provider Information

NPI Number	:	1811042187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHARINE COFFIN HULSE M.ED., ITDS

Provider Business Mailing Address
First Line	:	1534 SEFFNER VALRICO RD
Second Line	:
City	:	SEFFNER
State	:	FL
Zip	:	33584-6150
Country	:	US
Telephone Number	:	813-689-4315
Fax Number	:

Provider Business Practice Location Address
First Line	:	7402 N 56TH ST
Second Line	:	SUITE 906
City	:	TAMPA
State	:	FL
Zip	:	33617-7733
Country	:	US
Telephone Number	:	813-988-7633
Fax Number	:	813-914-0403

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2007
Last Update Date	:	09/11/2025

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