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Individual

MR. RANDY A HULTBERG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
506 HOPKINSVILLE ST, GREENVILLE, KY 42345-1104
(270) 338-5211
(270) 338-1624
Mailing address
PO BOX 614, HOPKINSVILLE, KY 42241-0614
(270) 886-2205
(270) 886-0392

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
804
KY
1041C0700X
Clinical Social Worker
LSW0000000611
TN

Other

Enumeration date
07/20/2006
Last updated
05/06/2019
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