Healthcare Provider Details

I. General information

NPI: 1194043950
Provider Name (Legal Business Name): JAMIE MAYE HULSEY B.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2010
Last Update Date: 05/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1604 N WASHINGTON AVE
DURANT OK
74701-2128
US

IV. Provider business mailing address

PO BOX 2024
POTTSBORO TX
75076-2024
US

V. Phone/Fax

Practice location:
  • Phone: 903-271-8225
  • Fax:
Mailing address:
  • Phone: 903-271-8225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: