Healthcare Provider Details

I. General information

NPI: 1376761759
Provider Name (Legal Business Name): JANE MATHESON HULL MS., LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

832 BRUNSWICK AVE
TRENTON NJ
08638
US

IV. Provider business mailing address

51 DOYLE ST
DOYLESTOWN PA
18901-3746
US

V. Phone/Fax

Practice location:
  • Phone: 609-396-8877
  • Fax: 609-396-6042
Mailing address:
  • Phone: 267-247-5339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC37PC00061900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: