Individual
ERIN MARIE DI FULVIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.S.A.C.
Contact information
Practice address
5965 S 900 E, SALT LAKE CITY, UT 84121-1720
(801) 359-8862
Mailing address
2200 S STATE ST, SALT LAKE CITY, UT 84115-2724
(801) 359-8862
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
7810932-6005
UT
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
03/18/2011
Last updated
04/18/2012
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