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Individual

SAMANTHA FULP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
101 T ST NE, WASHINGTON, DC 20002-1519
(956) 278-0770
Mailing address
11001 W 120TH AVE STE 310, BROOMFIELD, CO 80021-3493
(956) 278-0770

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
119196
TX
225X00000X
Occupational Therapist
Primary
OT010001539
DC

Other

Enumeration date
06/12/2018
Last updated
04/06/2019
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