Provider Demographics
NPI:1043356553
Name:HULL, TANYA KAY (LPC)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:KAY
Last Name:HULL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3607 CHAIN BRIDGE RD STE A
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-3242
Mailing Address - Country:US
Mailing Address - Phone:703-591-8778
Mailing Address - Fax:703-222-5030
Practice Address - Street 1:3607 CHAIN BRIDGE RD STE A
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-3242
Practice Address - Country:US
Practice Address - Phone:703-591-8778
Practice Address - Fax:703-222-5030
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003068101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional