Provider Demographics
NPI:1558782466
Name:HULST, HOLLY E (LMFT)
Entity Type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:E
Last Name:HULST
Suffix:
Gender:F
Credentials:LMFT
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 1611
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-0197
Mailing Address - Country:US
Mailing Address - Phone:360-697-1141
Mailing Address - Fax:360-697-2395
Practice Address - Street 1:20174 FRONT ST NE
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-7445
Practice Address - Country:US
Practice Address - Phone:360-697-1141
Practice Address - Fax:360-697-2395
Is Sole Proprietor?:No
Enumeration Date:2013-12-18
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60407830106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist