Provider Demographics
NPI:1922200658
Name:GULLA, JAMES P
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:P
Last Name:GULLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 HOLLOW OAK DR
Mailing Address - Street 2:
Mailing Address - City:SANDOWN
Mailing Address - State:NH
Mailing Address - Zip Code:03873-2113
Mailing Address - Country:US
Mailing Address - Phone:603-893-8096
Mailing Address - Fax:603-887-5341
Practice Address - Street 1:130 MAIN ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-3176
Practice Address - Country:US
Practice Address - Phone:603-893-8096
Practice Address - Fax:603-887-5341
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH342101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health