Individual
JACLYN A FULMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
1502 SPRUCE AVE, WILMINGTON, DE 19805-2148
(302) 552-3700
Mailing address
1502 SPRUCE AVE, WILMINGTON, DE 19805-2148
(215) 833-2349
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
O1-0001828
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01-0001828
—
DE
Enumeration date
07/08/2020
Last updated
07/08/2020
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