Susan H Hull, PHD
Individual provider Active NPI Clinical Psychologist · Bandera, TX
NPI 1174516884 · NPPES record last updated Apr 14, 2020
Key facts
- NPI
- 1174516884
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- TX22945 (TX)
- Practice address
- 935 Rikki Dr
Bandera, TX 78003-5925 - Phone
- (210) 872-1713
- Fax
- (210) 492-6418
- NPI assigned
- Aug 27, 2005
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TX22945 | TX | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | TX22945 | TX | Yes |
Addresses
Primary practice location
935 Rikki Dr
Bandera, TX 78003-5925
Mailing address
PO Box 3661
Bandera, TX 78003-6661
Phone (210) 872-1713
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 032630801 | Medicaid | TX |
Other providers in Bandera, TX
- Melany Ann Higdon
- Hill Country Mobile Chiropractic LLC
- Stacia Hood Lankford
- Autura Hopkins
- Maria Elise Horgan
- Gregory S Hupp
- Sandra Lynn Ingram
- Latonya Jackson
- JH Wellness PLLC
- Amanda Raye Jones
All providers in Bandera, TX · Clinical Psychologist in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 14, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.