Individual
ERIN FULLERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SPEDMS
Contact information
Practice address
3420 WOODWARD AVE, WANTAGH, NY 11793-4032
(631) 512-9324
Mailing address
3420 WOODWARD AVE, WANTAGH, NY 11793-4032
(631) 512-9324
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
504539
NY
Other
Enumeration date
06/26/2012
Last updated
06/26/2012
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