Individual
CHARLY FULP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCMHC-A
Contact information
Practice address
1240 SE MAYNARD RD, CARY, NC 27511-6929
(919) 636-0762
Mailing address
1240 SE MAYNARD RD, CARY, NC 27511-6929
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
A16790
NC
Other
Enumeration date
07/20/2021
Last updated
07/20/2021
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