Provider Demographics
NPI:1477764629
Name:HULLEY, WILLIAM C (MDIV)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:C
Last Name:HULLEY
Suffix:
Gender:M
Credentials:MDIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4224
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80306-4224
Mailing Address - Country:US
Mailing Address - Phone:303-997-1280
Mailing Address - Fax:
Practice Address - Street 1:2299 PEARL ST
Practice Address - Street 2:SUITE 310
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-4668
Practice Address - Country:US
Practice Address - Phone:303-997-1280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9586106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist