Individual
MISS ALYCIA ANN FULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC SLP
Contact information
Practice address
510 CARPENTER AVE, MOORESVILLE, NC 28115-2512
(705) 663-2115
Mailing address
8900 WIN HOLLOW CT, CHARLOTTE, NC 28215-8746
(704) 598-7773
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9773
NC
Other
Enumeration date
10/22/2012
Last updated
10/22/2012
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