Individual
JOHN FULMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3402 FRANKLIN RD, CALDWELL, ID 83605-6932
(208) 459-0092
(208) 454-7714
Mailing address
3402 FRANKLIN RD, CALDWELL, ID 83605-6932
(208) 459-0092
(208) 454-7714
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-34739
ID
Other
Enumeration date
05/12/2016
Last updated
05/12/2016
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