Healthcare Provider Details

I. General information

NPI: 1205817798
Provider Name (Legal Business Name): CLAUDIA L HULTS MS CCC SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 OAK TREE CT
DELAND FL
32724-4832
US

IV. Provider business mailing address

510 OAK TREE CT
DELAND FL
32724-4832
US

V. Phone/Fax

Practice location:
  • Phone: 386-748-0920
  • Fax: 386-736-9856
Mailing address:
  • Phone: 386-736-9856
  • Fax: 386-736-9856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA797
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: