Provider Demographics
NPI:1811042187
Name:HULSE, KATHARINE COFFIN (MED, ITDS)
Entity Type:Individual
Prefix:MS
First Name:KATHARINE
Middle Name:COFFIN
Last Name:HULSE
Suffix:
Gender:F
Credentials:MED, ITDS
Other - Prefix:
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Mailing Address - Street 1:1534 SEFFNER VALRICO RD
Mailing Address - Street 2:
Mailing Address - City:SEFFNER
Mailing Address - State:FL
Mailing Address - Zip Code:33584-6150
Mailing Address - Country:US
Mailing Address - Phone:813-689-4315
Mailing Address - Fax:
Practice Address - Street 1:7402 N 56TH ST
Practice Address - Street 2:SUITE 906
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617-7733
Practice Address - Country:US
Practice Address - Phone:813-988-7633
Practice Address - Fax:813-914-0403
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NONE174400000X
222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered174400000XOther Service ProvidersSpecialist
Not Answered222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist