Healthcare Provider Details

I. General information

NPI: 1083647168
Provider Name (Legal Business Name): KATHRYN T HULS PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 09/24/2021
Certification Date: 09/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8091 RANDOLPH ST
HOBART IN
46342-7068
US

IV. Provider business mailing address

1608 LINCOLNWAY STE G
VALPARAISO IN
46383-5852
US

V. Phone/Fax

Practice location:
  • Phone: 219-940-3645
  • Fax:
Mailing address:
  • Phone: 773-935-4700
  • Fax: 773-935-4701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6301010809
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number914179
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number20040963A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number20040963
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: