Healthcare Provider Details

I. General information

NPI: 1245906536
Provider Name (Legal Business Name): TAMARA ADRIENNE HULL LCMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2021
Last Update Date: 03/22/2024
Certification Date: 03/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10705 CHARTER DR STE 410
COLUMBIA MD
21044-2800
US

IV. Provider business mailing address

3329 G HAMPTON POINT DRIVE
SILVER SPRING MD
20904
US

V. Phone/Fax

Practice location:
  • Phone: 240-295-3116
  • Fax:
Mailing address:
  • Phone: 240-401-1423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLGM837
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLCM1003
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: