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Individual

DR. MARK G TULLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
4150 BELDEN VILLAGE ST NW, SUITE 110, CANTON, OH 44718-2595
(330) 492-8383
(330) 492-6530
Mailing address
7165 QUEENSGATE ST NW, CANTON, OH 44718-1597
(330) 830-9302
(330) 492-6530

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4379
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0961231
OH
Enumeration date
12/28/2006
Last updated
07/08/2007
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