Provider Demographics
NPI:1972960284
Name:HULL, JULIE (MA)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:HULL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:881 GOVERN CIR
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55123-2460
Mailing Address - Country:US
Mailing Address - Phone:651-485-7721
Mailing Address - Fax:
Practice Address - Street 1:881 GOVERN CIR
Practice Address - Street 2:6600 FRANCE AVENUE SOUTH, SUITE 164
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55123-2460
Practice Address - Country:US
Practice Address - Phone:651-485-7721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-19
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN17611101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral