Healthcare Provider Details

I. General information

NPI: 1285159608
Provider Name (Legal Business Name): GEMELL HULBERT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2017
Last Update Date: 08/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5640 READ BLVD STE 740
NEW ORLEANS LA
70127-3131
US

IV. Provider business mailing address

5640 READ BLVD STE 740
NEW ORLEANS LA
70127-3131
US

V. Phone/Fax

Practice location:
  • Phone: 504-245-2440
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: