Individual
MR. FRED FULTON IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
501 BROADWAY ST, DELHI, LA 71232-3001
(318) 878-8658
Mailing address
109 LARCHE DR, WEST MONROE, LA 71291-5401
(318) 651-9626
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
10/17/2014
Last updated
06/02/2021
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