Provider Demographics
NPI:1760811731
Name:HULLET, EMILY BETH
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:BETH
Last Name:HULLET
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1925 GREENWAY AVE
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-5647
Mailing Address - Country:US
Mailing Address - Phone:405-210-1604
Mailing Address - Fax:
Practice Address - Street 1:1925 GREENWAY AVE
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-5647
Practice Address - Country:US
Practice Address - Phone:405-210-1604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-10
Last Update Date:2013-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKL081472873174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator