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1902117831
STACEY FULKERSON
PROVIDENCE, RI
NPI
1902117831
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: RI OT00162-G)
Enumeration Date
2010-06-25
Last Update Date
2010-06-25
Business Address
-- STACEY FULKERSON OT
1000 EDDY STREET
PROVIDENCE, RI 02905
Phone number: 401-533-9100
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Mailing Address
-- STACEY FULKERSON OT
1000 EDDY STREET
PROVIDENCE, RI 02905
Phone number: 401-533-9100
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