Provider Demographics
NPI:1902133812
Name:HULL, MARLA L (BSW, LMSW)
Entity type:Individual
Prefix:MRS
First Name:MARLA
Middle Name:L
Last Name:HULL
Suffix:
Gender:F
Credentials:BSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20960 KELLY RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:EASTPOINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48021-3137
Mailing Address - Country:US
Mailing Address - Phone:586-585-1955
Mailing Address - Fax:586-585-1963
Practice Address - Street 1:20960 KELLY RD
Practice Address - Street 2:SUITE B
Practice Address - City:EASTPOINTE
Practice Address - State:MI
Practice Address - Zip Code:48021-3137
Practice Address - Country:US
Practice Address - Phone:586-585-1955
Practice Address - Fax:586-585-1963
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-13
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010162771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical