Provider Demographics
NPI:1578897013
Name:HULTQUIST, ANDREW (BA)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:HULTQUIST
Suffix:
Gender:M
Credentials:BA
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Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:33 HIGHLAND STREET,
Mailing Address - Street 2:1ST FLOOR HOSPITAL OF CENTRAL CONNECTICUT
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06052
Mailing Address - Country:US
Mailing Address - Phone:860-224-9919
Mailing Address - Fax:860-612-0009
Practice Address - Street 1:33 HIGHLAND STREET
Practice Address - Street 2:HOSPITAL OF CENTRAL CONNECTICUT,1ST FLOOR
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052
Practice Address - Country:US
Practice Address - Phone:860-224-9919
Practice Address - Fax:860-612-0009
Is Sole Proprietor?:No
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor