Individual
BRENDA R. FULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
104 9TH AVE S STE A6, NAMPA, ID 83651-3809
(208) 960-0365
Mailing address
750 S WESTON CREEK LOOP, NAMPA, ID 83686-5655
(208) 992-6530
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-44566
ID
Other
Enumeration date
01/23/2024
Last updated
04/04/2025
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