Individual
LAURA REGINA FULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
301 PALMETTO PARK BLVD, LEXINGTON, SC 29072-7872
(803) 996-1500
(803) 996-1510
Mailing address
301 PALMETTO PARK BLVD, LEXINGTON, SC 29072-7872
(803) 996-1500
(803) 996-1510
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6639
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PC1939
—
SC
Enumeration date
12/02/2011
Last updated
10/15/2019
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