Healthcare Provider Details

I. General information

NPI: 1255188793
Provider Name (Legal Business Name): JOANNA L. HULL BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2024
Last Update Date: 05/02/2024
Certification Date: 05/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

579 S BARRE RD
BARRE VT
05641-8107
US

IV. Provider business mailing address

PO BOX 647
MONTPELIER VT
05601-0647
US

V. Phone/Fax

Practice location:
  • Phone: 802-479-0012
  • Fax: 802-476-6445
Mailing address:
  • Phone: 802-479-0012
  • Fax: 802-476-6445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number146.0134139
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: