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Individual

MR. MICHAEL HUGH FULKERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MAE, LPCC

Contact information

Practice address
1100 WALNUT ST, OWENSBORO, KY 42301-2956
(270) 689-6681
(270) 689-6677
Mailing address
3731 FREDERICA ST, OWENSBORO, KY 42301-6975
(270) 689-6681
(270) 689-6677

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
104746
KY
101YP2500X
Professional Counselor
KY - 0223
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100337270
KY
Enumeration date
06/25/2014
Last updated
06/06/2016
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