Provider Demographics
NPI:1881043925
Name:HULICK, AUDREE ADELE
Entity Type:Individual
Prefix:
First Name:AUDREE
Middle Name:ADELE
Last Name:HULICK
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 1:10549 FAWN RIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:HARTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48353-2553
Mailing Address - Country:US
Mailing Address - Phone:248-535-9589
Mailing Address - Fax:
Practice Address - Street 1:10549 FAWN RIDGE TRL
Practice Address - Street 2:
Practice Address - City:HARTLAND
Practice Address - State:MI
Practice Address - Zip Code:48353-2553
Practice Address - Country:US
Practice Address - Phone:248-535-9589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other