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General NPI Number Information
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NPI Number | 1093497075
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Entity Type | Individual
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Provider Name | TERESA HULSEY PHD
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Gender | Female
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Dates
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Enumeration Date | 08/01/2023
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 307 E GOVERNMENT ST STE A
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City | BRANDON
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State | MS
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Zip | 39042-3238
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Country | US
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Telephone | 769-210-4593
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Fax |
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Provider Business Mailing Address
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Address Line | 404 STONEYBROOK DR
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City | BRANDON
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State | MS
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Zip | 39042-3501
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 621109
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License Number State | MS
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