Individual
KENNETH EDWARD HULTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
966 LAA LA WAY, DIAMONDHEAD, MS 39525-4122
(228) 327-5375
Mailing address
966 LAA LA WAY, DIAMONDHEAD, MS 39525-4122
(228) 327-5375
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC0147
MD
Other
Enumeration date
03/24/2021
Last updated
03/24/2021
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