Healthcare Provider Details

I. General information

NPI: 1073306155
Provider Name (Legal Business Name): ANDREW PULLMAN PLPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2025
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 N RANGE AVE STE A
DENHAM SPRINGS LA
70726-3447
US

IV. Provider business mailing address

125 N RANGE AVE STE A
DENHAM SPRINGS LA
70726-3447
US

V. Phone/Fax

Practice location:
  • Phone: 225-505-9383
  • Fax:
Mailing address:
  • Phone: 225-505-9383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPLC10683
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: