Doctor Name: | MS. DEBRA KAYE TULLIS |
NPI Number: | 1821164260 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW, LCSW, BCD |
License Number: | |
Business Practice Address: | 6 Dunlap Ct Savoy, IL - 618749501 |
Business Phone Number: | 2174938186 |
Business Fax Number: | 2173593931 |
Mailing Address: | 2812 Cherry Hills Dr, CHAMPAIGN |
State: | IL |
Postal Code: | 618227540 |
Phone Number: | 2174938186 |
Fax Number: | 2173593931 |
NPI Enumeration Date: | 11/28/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |