Individual
MISS OLIVIA MARIE FULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC-R, QMHA-R
Contact information
Practice address
687 CHESHIRE AVE, EUGENE, OR 97402-5060
(541) 666-6277
Mailing address
1313 LINCOLN ST APT 206, EUGENE, OR 97401-3923
(541) 666-6277
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
07/29/2020
Last updated
07/29/2020
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