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Individual

CAROLYN DIANA FULCHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
215 HAWKS RD STE 12A, MARTIN, TN 38237-2708
(731) 281-8070
(731) 284-0533
Mailing address
212 HAWKS ROAD, SUITE 12A, MARTIN, TN 38237-2165
(731) 281-8070
(731) 284-0533

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6193
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
Q015002
TN
Enumeration date
07/21/2011
Last updated
03/14/2025
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