Healthcare Provider Details

I. General information

NPI: 1396863932
Provider Name (Legal Business Name): HULSEY SPEECH PATHOLOGY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

519 BEAUMONT RD
FAYETTEVILLE NC
28304-4424
US

IV. Provider business mailing address

519 BEAUMONT RD
FAYETTEVILLE NC
28304-4424
US

V. Phone/Fax

Practice location:
  • Phone: 910-257-2005
  • Fax: 910-485-6315
Mailing address:
  • Phone: 910-257-2005
  • Fax: 910-485-6315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. KYLE TANNER HULSEY
Title or Position: PRESIDENT
Credential: SLP
Phone: 910-257-2005