| NPI | 1619018256 |
|---|---|
| Professional Name | MARY FULTON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 23222) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2007-07-08 |