NPI | 1952748535 |
---|---|
Former Name | SANDRA L FULTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW18181) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MD 15727) |
1041C0700X Social Worker, Clinical (Licence: FL 18181) | |
Enumeration Date | 2013-05-23 |
Last Update Date | 2023-04-18 |