Individual
TERRI FULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
29 N ACADEMY ST, GREENVILLE, SC 29601-2629
(643) 311-4008
(864) 331-1416
Mailing address
29 N ACADEMY ST, GREENVILLE, SC 29601-2629
(643) 311-4008
(864) 331-1416
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
SL000835 L
PA
235Z00000X
Speech-Language Pathologist
Primary
SL000835 L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001862010004
—
PA
01
—
1354279
HIGHMARK
PA
01
—
163616
MEDPLUS
PA
01
—
2653150
AETNA HMO
PA
01
—
7721306
AETNA HMO
PA
01
—
819174
FIRST PRIORITY/BC/BS
PA
Enumeration date
12/02/2005
Last updated
06/20/2019
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