Provider Demographics
NPI:1982197372
Name:SIN, NULHAE
Entity type:Individual
Prefix:
First Name:NULHAE
Middle Name:
Last Name:SIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9000 SOUTHSIDE BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-0793
Mailing Address - Country:US
Mailing Address - Phone:904-732-4343
Mailing Address - Fax:904-562-3466
Practice Address - Street 1:9000 SOUTHSIDE BLVD BLDG 900
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-0791
Practice Address - Country:US
Practice Address - Phone:904-732-4343
Practice Address - Fax:904-562-3466
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst