Healthcare Provider Details

I. General information

NPI: 1972874121
Provider Name (Legal Business Name): SHERRY LYNN HULSEY M.ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2012
Last Update Date: 09/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 AVENUE OF AMERICA
MONROE LA
71201
US

IV. Provider business mailing address

1818 AVENUE OF AMERICA
MONROE LA
71201
US

V. Phone/Fax

Practice location:
  • Phone: 318-998-2700
  • Fax: 318-998-2703
Mailing address:
  • Phone: 318-998-2700
  • Fax: 318-998-2703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4624
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: