Individual
MAUREEN FULKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED, LPC
Contact information
Practice address
5675 STONE RD, SUITE 300, CENTREVILLE, VA 20120-1667
(571) 289-6725
Mailing address
5675 STONE RD, CENTREVILLE, VA 20120-1667
(703) 862-2206
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701005684
VA
Other
Enumeration date
06/30/2014
Last updated
10/22/2014
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