ANDY LEROY FULTON

SANTA ROSA, CA
NPI1265864821
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  F1101261615)
Enumeration Date2013-08-06
Last Update Date2013-08-06
Business Address
Mr. ANDY LEROY FULTON RAS
1901 CLEVELAND AVENUE, #B
SANTA ROSA, CA 95401
Phone number: 707-576-0818
Mailing Address
Mr. ANDY LEROY FULTON RAS
1901 CLEVELAND AVENUE #B SANTA ROSA TREATMENT PROGRAM
SANTA ROSA, CA 95401
Phone number: 707-576-0818
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