Individual
SUE ANN FULTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA., LBS
Contact information
Practice address
1607 3RD ST, BEAVER, PA 15009-2420
(724) 728-8400
(724) 728-7666
Mailing address
1607 3RD ST, BEAVER, PA 15009-2420
(724) 728-8400
(724) 728-7666
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH001306
PA
Other
Enumeration date
03/17/2014
Last updated
03/17/2014
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