Healthcare Provider Details

I. General information

NPI: 1336618271
Provider Name (Legal Business Name): BETH ANN HULL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2018
Last Update Date: 11/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ROCKVIEW PL
BELLEFONTE PA
16823-1664
US

IV. Provider business mailing address

1 ROCKVIEW PL
BELLEFONTE PA
16823-1664
US

V. Phone/Fax

Practice location:
  • Phone: 814-355-4874
  • Fax:
Mailing address:
  • Phone: 814-355-4874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC010878
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: