Provider Demographics
NPI:1396863932
Name:HULSEY SPEECH PATHOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:HULSEY SPEECH PATHOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:TANNER
Authorized Official - Last Name:HULSEY
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:910-257-2005
Mailing Address - Street 1:519 BEAUMONT RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-4424
Mailing Address - Country:US
Mailing Address - Phone:910-257-2005
Mailing Address - Fax:910-485-6315
Practice Address - Street 1:519 BEAUMONT RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-4424
Practice Address - Country:US
Practice Address - Phone:910-257-2005
Practice Address - Fax:910-485-6315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8301270Medicaid