Individual
JESSICA FULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
508 FULTON ST, DURHAM, NC 27705-3875
(919) 286-0411
Mailing address
23 SUNCREST CT, DURHAM, NC 27703-4913
(919) 491-2011
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
103024
NC
Other
Enumeration date
07/02/2013
Last updated
07/02/2013
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